CARE AND FEEDING 
/'THE INFANT 

GEORGE D.XYMAN, A. B..M.D. 




Class , 

Book i 

Copyright N°_ 



COPYRIGHT DEPOSIT. 



CARE AND FEEDING 
of THE INFANT 



CARE <£ FEEDING 
of THE INFANT 

PRACTICAL ADVICE 

FOR MOTHERS AND NURSES 

By GEORGE D. LYMAN 

A.B.,M.D." 

WITH AN INTRODUCTION 

By RAY LYMAN WILBUR, M. D. 

DEAN of COLLEGE OF MEDICINE 

LELAND STANFORD JR. 

UNIVERSITY 



1 

OH 


\ 


1 



PAUL ELDER AND COMPANY 
PUBLISHERS SAN FRANCISCO 



Copyright, 1915 

Paul Elder $ Company 

San Francisco 



Lai 



/ £*> 






to 



D. V. L. 

AND HER DAUGHTERS 

DOROTHY QUINCY AND 

ELIZABETH ANNE 



CONTENTS 

Introduction . . . . • . . . IX 

Rules for the Mother Preceding the Baby's 

Birth 3 

Examination of the New-Born Infant . . 7 

Physical and Mental Development of the 

Infant 15 

Weight — Measurements — Muscular De- 
velopment — The Teeth — Special Senses — 
Sleep, Etc. 

Care of the New-Born Babe 25 

The Cord — Eyes — Genitalia — Sponging 
and Bathing — The Nursery — The Bed — 
Baby Clothing and Diapers — The Baby 
Buggy — Kissing — Lifting and Carrying — 
Weighing — The Ears — Premature and 
Weak Babies — Asphyxia and Its Treat- 
ment. 

Infant Feeding 49 

Breast Feeding and Its Management — Wet 
Nursing and Its Management — Mixed 
Feeding: Breast and Bottle Combined — 
Feeding Breast-Fed Baby After Six 
Months — Weaning — Artificial Feeding and 
Its Management — Feeding After the First 
Year. 

The Most Frequent Complaints and Diseases 

of the Infant 89 

Inflammation of the Eyes — Scurf — In- 
tertrigo — Thrush — Soor — Stomatitis — 
Colic — Convulsions — Nasal Catarrh — Ear- 
ache — Constipation — Croup — Vomiting 
and Diarrhoea — Crying. 

VII 



CONTENTS 

Training of the Infant 103 

Playthings — Airing. 

Special Directions Ill 

Enemas — Taking the Temperature — Poul- 
tices — Packs — Compresses — Baths. 

Recipes ' . . 119 

Index 129 



VIII 



INTRODUCTION 

No problem is more absorbing to the young 
mother or the nurse than the details of the 
care of a new-born infant. Conscientious, 
painstaking attention is the rule, and it is most es- 
sential that anything done shall be done right. The 
care of the eyes, of the mouth, of the cord, are all 
simple enough, but they can be carried on with 
great exactness along the wrong lines unless one 
has knowledge of the correct methods. One can, 
not infrequently, trace illness or failure to gain and 
grow to simple, easily remediable faults in the 
baby's care. Dr. Lyman has brought together with 
clear insight many of the simple but important 
facts in the rearing of infants. I feel that his book 
will be a great aid to nurses and mothers in one 
of the most beautiful and pleasant duties of life, 
and yet one of the most important and far-reaching. 
There is a universal appeal in a baby's smiles. We 
must not be led by it to merely make a plaything 
of the child. We must see in the infant the future 
son or daughter, the future citizen, and do all that 
we can, day in and day out, to see that develop- 
ment is steady and sound along physical, mental 
and moral lines. May Dr. Lyman's book prove 
as helpful to its readers as the lectures upon which 
it is based have to the nurses who have heard them. 

Ray Lyman Wilbur, 

Dean of College of Medicine, 

Leland Stanford Jr. University. 

February 22, 1915. 



IX 



RULES FOR THE 

MOTHER PRECEDING THE 

BABY'S BIRTH 



RULES FOR THE MOTHER PRE- 
CEDING THE BABY'S BIRTH 

The care of the infant begins with the preg- 
nancy of the mother, and she should consult 
a reputable physician as soon as possible so 
that she may do everything to promote the develop- 
ment of her unborn babe. 

She should lead as quiet and regular a life as 
possible, avoiding everything and anything too 
strenuous for mind or body. She should not at- 
tend plays, read books or frequent company which 
destroy the peace of her mind or get her in an 
over-excited condition. She should take exercise 
every day, preferably by walking in the open air. 
Dancing, gymnastics, tennis, swimming and horse- 
back riding are best avoided. She should go to 
bed early and sleep at least ten hours. Immediately 
after the noon-day meal she should lie down for 
half an hour. 

The expectant mother can eat almost anything 
which she enjoys and relishes. Only excesses 
should be avoided, particularly over-eating; alco- 
holic drinks, strong teas and coffee, rich foods 
and salads are best eliminated. A diet rich in 
milk, vegetables and fruit is to be recommended; 
vegetables especially, as they aid in avoiding the 
constipation which is especially troublesome at 
this period. 

The clothes should be loose, warm and not 
heavy. Anything pressing on the abdomen and 
hindering the free development of the infant should 
be done away with. On this account corsets should 
be early cast aside and garments worn especially 
designed for this purpose. The legs and the ab- 
domen must be kept warm. High-heeled shoes 
and garters are to be eliminated. 



CARE AND FEEDING OF THE INFANT 

Baths 

If the mother to be is accustomed to a daily 
bath, it can be continued. It must not be cold 
enough to be a shock to the system or hot enough 
to be weakening. 

The Breasts 

The breasts must be prepared for the duties 
ahead. During pregnancy they increase in size. 
Too tight clothing, especially corsets, can by pres- 
sure hinder the development of the nipples. They 
are apt to grow in or are so insufficiently developed 
that they can not be retained in the mouth of the 
nursing infant. Further, pressure makes the skin 
about the nipple so tender that in the first few 
days following birth it becomes sensitive, fissured 
and torn. 

During the last month of pregnancy if the nip- 
ples are poorly developed they should be carefully 
pulled out and gently massaged night and morning. 
If this does not appear successful a breast pump 
can be used and the nipples drawn out several 
times daily. 

To harden the nipples cold water sponging 
should be given night and morning. Sometimes a 
little diluted alcohol is good. However, the latter 
should be used only under the direction of a phy- 
sician, as it is apt to do more harm than good. 
The alcohol is used with the idea of hardening 
the skin and so preventing fissures, tenderness, etc., 
later. 



EXAMINATION OF THE 
NEW-BORN INFANT 



EXAMINATION OF THE 
NEW-BORN INFANT 

It is hard to imagine any living thing more 
helpless than the new-born infant, in fact, it 
is said to be the most helpless of all. The 
young of most species have a highly developed 
instinct and can in part look out for themselves. 
For instance, the new-born chicks are able to walk 
and obtain food for themselves — not so the infant. 
It lies where it is put absolutely helpless and ab- 
solutely dependent on some one to take care of 
it. Neither is it beautiful to look upon, this new- 
born babe. The head and chest are of about an 
equal size and there is no trace of a neck; the 
abdomen is prominent and protruding; the arms 
and legs are short and clumsy and their movements 
inco-ordinated; the skin and mucus membrane are 
very red, but become pale in a few days; in places 
the skin is covered with light hairs or lanugo, which 
disappear shortly. 

The head is covered with short hairs about one 
inch long. This falls out during the first two weeks. 
If it has been a long difficult labor the bones of 
the head often overlap and the sides are asymmetri- 
cal. The anterior and posterior fontanelles are 
open, the anterior being the larger of the two. The 
bones should be perfectly firm and there should 
be no separation at the suture line. 

A full term infant should be between twenty 
and twenty-one inches long and should weigh seven 
or seven and one-quarter pounds. The boys weigh a 
little more than the girls. The chest and head 
circumference are about equal — thirty-four cm. 
The cartilage of the nose and ear should be firm 
and nails should be flush with the ends of the 
fingers and toes. These points should be kept in 
mind, as a prematurely born babe requires ab- 
solutely different handling from a full term infant. 



CARE AND FEEDING OF THE INFANT 

Pulse and Respiration 
The respiration and pulse vary considerably. 
In the first month the respirations are between 
thirty and sixty, averaging about thirty-five to the 
minute; during the second year about twenty-five. 
The pulse averages between one hundred and thirty 
and one hundred and forty per minute. 

The Urine 

The urine is practically colorless, sometimes 
cloudy. It is passed from twenty to twenty-five 
times during the twenty-four hours; during the day 
it is more frequent than at night. Often there is 
a reddish brown spot found in the diapers; this is 
not blood but is due to uric acid crystals. Often 
the urine of the new r -born gives the reaction for 
albumen, with acetic acid; this is due to the 
action of the acid on the bladder and ureteral cells 
present. The urine of premature babies at times 
shows the reaction for sugar. 

The Stools 

The stools of the first two days are dark brown 
in color; they have the consistency of tar and are 
composed of epithelial cells, hair, mucus, gall and 
cholestrin crystals, and are called Meconium. The 
first breast-milk stool appears usually on the third 
day, and is golden yellow and has a sour, but not 
unpleasant odor. Two or three stools a day are 
a perfectly normal number. A babe is on record 
who had ten stools a day; they were well digested, 
normal stools but small in quantity — not more than 
a thimbleful. The child gained and thrived and 
apparently had no intestinal abnormalities. When 
a child has more than three stools daily and if 
they are loose, full of mucus, etc., a physician 
should be summoned and nothing but boiled water 
should be given by mouth. 

8 



EXAMINATION OF NEW-BORN INFANT 

The Temperature 

The temperature of the new-born fluctuates be- 
tween 97.5° and 100.0° F. The heat center in the 
brain of new-born babies functionates very irreg- 
ularly and slight causes disturb it completely. A 
subnormal temperature or one of 99° to 100° is of 
no importance unless it continues. With slight 
provocation an infant will run a high temperature 
which a few hours later will be normal. When 
it does not persist and is not accompanied by other 
pathological symptoms it should not excite alarm. 

Infants are extremely sensitive to the surround- 
ing temperature. A slight chilling will reduce it 
one-half to one degree and a hot water bottle in 
the immediate vicinity will elevate it one or two 
degrees. 

The temperature should always be taken by 
rectum. Axillary and groin temperatures are prac- 
tically worthless. There are too many conditions 
which influence it one way or the other. 

The Stomach 
The stomach of the new-born is not in a hori- 
zontal position, as in the adult, but lies almost 
vertical. On this account the mother must be very 
careful in handling the baby after feeding; all the 
food is apt to be pressed out. In fact, a baby is 
like a wet sponge, which retains all the fluid if 
not unduly squeezed. After each feeding it should 
lie unmolested in its bed for ten or fifteen minutes. 

The Nervous System and Sleep 
The nervous system is very weak and inco- 
ordinated. This displays itself by the inco-ordinate 
movements of arms, legs and eyes, but especially 
by the tendency to sleep. This sleepiness is over- 
whelming at first. The infant is exhausted by the 
labor and immediately after being sponged and 
clothed, sinks into a deep sleep, from which, during 

9 



CARE AND FEEDING OF THE INFANT 

the whole first day, it does not awaken, and dur- 
ing the second day only when it is hungry or 
uncomfortable. Most often it has to be awakened 
to be fed. The normal position of the sleeping 
infant is with both arms bent at the elbow and 
thrown parallel with the head; both fists are 
doubled and are on a level with the ears. 

Of the special senses only those are early de- 
veloped which are necessary for the new-born 
babe — temperature, pain, taste and smell. Hearing 
and seeing are developed later. The full develop- 
ment of these senses is not reached until the end 
of the third month. However, the new-born are 
very sensitive to loud noises and bright lights and 
should be protected from them. 

Abnormalities and Malformations 

The new-born babe should be examined for ab- 
normalities and malformations. 

For cleft palate and hair lip the services of 
a physician are necessary. Often it is impossible 
for the baby to nurse from the breast or suck 
from the bottle and there is danger of aspiration 
into the windpipe. 

The physician should also ascertain whether the 
genitourinary and anal orifices are patent. 

There are several normal manifestations which 
are often mistaken for abnormalities which should 
not excite anxiety: 

The Caput Succedaneum 

Which is an oedema of the scalp, due to pres- 
sure over the part of the head which presents. It 
gets well of itself in a few days and does not need 
especial attention, unless sloughing sets in. When 
this pressure tumor contains blood it is called a 
cephalhaematoma. It disappears usually in two to 
three months and generally requires no treatment. 



10 



EXAMINATION OF NEW-BORN INFANT 

Lanugo 

The short hairs on the lobes of the ears and 
the shoulders are called lanugo. They disappear 
without treatment. 

Icterus of the New-born 

This is a manifestation often observed in new 
babies which is apt to cause great anxiety. Holt 
says that out of nine hundred births at the Sloane 
Maternity Hospital icterus was noted in one-third. 
This jaundice occurs during the first two days of 
life, and generally terminates at the end of five 
or six days. It does not require treatment. If 
it lasts longer than the time specified and is ac- 
companied by fever and other symptoms a doctor 
should be summoned. Icterus of the new-born is 
a physiological manifestation. After the cord has 
been tied off the blood circulation follows another 
course through the liver. This results in an in- 
crease of blood in that organ, and with the in- 
crease of blood there is an increased production 
of bile. As the gall ducts are already filled with 
bile, the increased amount passes into the circula- 
tion and becomes apparent in skin and mucus mem- 
brane. 

Swelling of the Breasts 

Is another manifestation in the new-born which 
excites anxiety. It is due to the same stimulus 
which increases the size of the mother's breasts. 
It is said to be present in every babe, male and 
female alike. With some babies it is more promi- 
nent than others. It begins on the second to fourth 
day and disappears in a week. On pressure a drop 
of milk appears. The Germans call it Hexenmilch 
or witch milk. Most always it requires no treat- 
ment. If the breasts are very hard it is well to 
protect them from pressure and rubbing by a 
gauze bandage. It is a mistake to press the milk 
out, as there is danger of infection. 

11 



CARE AND FEEDING OF THE INFANT 

With girl babies there is often a bloody dis- 
charge from the vagina. This may be physiological 
in nature. At any rate, it is best to consult a 
physician. 

There is one other manifestation of the new- 
born which occurs frequently and which demands 
the most careful attention; that is inflammation of 
the eyes with formation of pus. Under all cir- 
cumstances a physician should be summoned im- 
mediately. There is danger of the infant losing 
the sight of one or both eyes. Our asylums for 
the blind are filled with youngsters whose eyes 
might have been saved had they received adequate 
treatment early. 



12 



PHYSICAL AND 

MENTAL DEVELOPMENT OF 

THE INFANT 



PHYSICAL AND MENTAL DEVELOP- 
MENT OF THE INFANT 

Weight 

As before mentioned, the infant weighs be- 
tween seven and seven and one-quarter 
^ pounds at birth; the males more than the 
females. But during the first few days the infant 
receives almost no food to make up for the losses 
through the urine, the stools, the skin, the respira- 
tion and the regurgitated liquor amnii swallowed 
during birth, so that before the first week is up 
it loses between one-ninth and one-tenth of its 
birth weight. This is not regained before the tenth 
to the twentieth day. 

According to Finkelstein, at the end of six 
months the weight should be twice the birth weight, 
and at the end of a year it should be tripled. An- 
other rule is as follows: It is necessary to figure 
in grams, remembering that approximately there 
are five hundred grams to one pound; for the first 
five months the babe should gain an average of six 
hundred grams per month and for the second half 
of the year five hundred grams per month, so the 
weight at any one month may be obtained by 
adding the birth weight in grams to the product 
of the month by six hundred and five hundred, 
as the case may be. 

For instance, a baby weighing at birth thirty- 
five hundred grams, or approximately seven 
pounds, should weigh at the end of six months 
6X60{)=3600+3500=7100, or approximately four- 
teen pounds. 

For the first month the baby gains about four 
ounces per week; for the second month about one 
ounce daily. If less than this it is not a cause 
for worry. A good average gain per week is four 
ounces. That a baby gains is the main issue. From 
the second to the sixth month its daily gain av- 

15 



CARE AND FEEDING OF THE INFANT 



erages two-thirds of an ounce, and from the end 
of six months on, about one-half ounce daily, so 
that at the end of the first year the boys weigh 
twenty-one pounds, the girls twenty pounds. 

Average Gain of Normal Babies Per Week 

First month weekly gain 4 < 

Second month " " 7 

Third month " " 5 

Fourth month " " 5 

Fifth month " " 6 

Sixth month " " 4% 

Seventh month " " 3% 

Eighth month " " 3% 

Ninth month " " 3 

Tenth month " " 2 

Eleventh month " " 2 

Twelfth month " " 2 

Average Weight for the First Year 
Birth Weight 7% Pounds 



Breast Fed Bottle Fed 



End 
End 
End 
End 
End 
End 
End 
End 
End 
End 
End 
End 
End 
End 
End 



of first week 7 lb. 

of second week 7 lb. 

of fourth week 7 " 

of eighth week 9 " 

of twelfth week 11 " 

of sixteenth week 12 " 

of twentieth week 13 " 

of twenty-fourth week 14 " 

of twenty-eighth week 15 " 

of thirty-second week 16 " 

of thirty-sixth week 17 " 

of fortieth week 18 " 

of forty-fourth week 19 " 

of forty-eighth week 19 " 

of fifty-second week 20 " 





7 1b 




8 oz. 


7 1b. 


2 


15 " 


7 " 


8 


10 " 


8 " 


9 


2 " 


9 " 


12 


8 " 


11 " 


10 


9 " 


12 " 


7 


11 " 


13 " 


14 


8 " 


14 " 


10 


5 " 


15 " 


9 


12 " 


16 " 


3 


10 " 


16 " 


10 


5 " 


17 " 


6 


14 M 


18 " 


2 


8 " 


19 M 


4 



2 oz. 



Height 



At birth the average baby is 20-21 inches long 
At six months " " " 25-26 

At one year " " " 28-29 

Head and Chest 

The circumference of the head and chest re- 
main about equal during the first year, at the end 
of that time averaging between 45.5 and 46 cm. 
On account of the moulding of the head during 

16 



DEVELOPMENT OF THE INFANT 

the process of birth, the bones are apt to overlap 
and the sides be asymmetrical. This should not 
excite alarm, as the proportions straighten out dur- 
ing the first few months providing the sleeping 
position is changed frequently. Otherwise an ob- 
liquity is apt to result. 

The posterior fontanelle closes about the second 
month; the anterior between the twelfth and fif- 
teenth month. If the anterior fontanelle closes be- 
fore the end of the first year, there is usually ar- 
rested mental development. If it is open after 
the twentieth month the infant should be examined 
for Rickets, Myxoedema, Cretinism or Hydro- 
cephalus. 

The Bones 

At the time of birth the bones are not com- 
pletely developed and are pliable. A slight bowing 
of the shins, flat feet and a symmetrical rounding 
of the back in sitting position, during the first 
months, are absolutely normal. With the develop- 
ment of the musculature these manifestations 
gradually disappear. Many anxious parents think 
these signs are due to Rickets, but Rickets does 
not usually develop until the fourth month; and 
its first appearance is heralded by cranio-tabes, or 
softening of the bones of the skull, restlessness and 
sweating of the head. 

Muscular Development 

At the end of three months the babe is able 
to hold its head up, when the body is supported; 
at the end of six months to sit up; at nine to ten 
months it crawls, and between eleven and twelve 
months stands on its feet. Between the twelfth 
and seventeenth months the first steps are taken. 
Many normal babies walk later. However, it has 
been noted that some babies begin to talk much 
earlier than to walk, and those walking earlier talk 
much later. Heredity appears to play some in- 

17 



8 


' 10 


" 12 


' 14 


" 12 


' 14 


" 18 


' 24 


" 18 


' 24 


" 20 


' 28 



CARE AND FEEDING OF THE INFANT 

fluence. If the mother or father have walked late 
their child is also apt to be tardy. 

The Teeth 

The first set, or milk teeth, twenty in number, 
appear between the seventh and twenty-eighth 
month as follows: 

1. The two lower central incisors between 6 and 8 month 

2. The four upper central incisors 

3. The other two lower central incisors 
and the first four molars 

4. The upper two canine or eye teeth.... 
and the lower two canine or stomach 

5. The four back molars 

Pfaundler's rule for the approximate estimation 
of the number of teeth an infant should have at 
a definite time is worth remembering. 

Z = Number of teeth. 
M = Age of infant in months. 
Z = M — 6. 

So an infant of 10 months should have 
four teeth, arrived at as follows: 

Z (teeth) = month — 6 
= 10 —6 

= 4 

If an infant has no teeth at eight to ten months 
a physician should be consulted. Delayed denti- 
tion occurs frequently with Rickets and Myxoedema. 
Abnormalities occur with Spasmophilia, Lues, 
Myxoedema and Mental Deficiencies. 

Often infants are born with one tooth. Fre- 
quently it is necessary to extract it, as it interferes 
with nursing and often traumatizes the mother's 
breast. 

Teething is not the cause of pathological con- 
ditions. Healthy infants usually experience no un- 
pleasant symptoms. Frequently it is accompanied 
by red, swollen and tender gums, by increase in 
the amount of saliva and drooling, by restlessness, 
irritability, crying, sleeplessness, loss of appetite 
and fever. 

18 



DEVELOPMENT OF THE INFANT 

Sometimes there are attacks of strophulus, urti- 
caria and other skin eruptions, diarrhoea and catarrh 
of the respiratory passages with cough and con- 
vulsions. Just whether these symptoms are due 
to teething is a question over which doctors are 
by no means agreed. Whenever teething is accom- 
panied by fever and other abnormal symptoms the 
mother should consult a physician and not say 
to herself that the baby is teething and let matters 
go — at this time the resistance is lowered and the 
infant is very susceptible to other affections and 
demands careful attention. 

The Special Senses 

As before mentioned, the senses of heat, cold, 
pain, taste and smell are present at birth. It is 
said the new-born babe can appreciate the differ- 
ence between fluids which are sweet and sour. 
Sour things cause it to screw up its face and turn 
its head away. Bottle-fed infants are very sus- 
ceptible to the slightest change in temperature or 
sweetness, and refuse it regularly if it is the least 
bit cold or not as sweet as usual. In this con- 
nection when the infant refuses the bottle the mouth 
and throat should be examined for thrush, stoma- 
titis, tonsillitis or pharyngitis. 

Sight 

At birth the infant is practically as blind as 
a new-born puppy. The pupils react to light and 
it has been said the eyes are turned in the direction 
of a bright light, but as for seeing it is impossible. 
A normal babe is able to fix its gaze, to follow 
a light, a match or bright object at the third month. 

Recognition of the father, mother and the nurse 
does not develop until between the fourth and 
fifth month. About this time the infant begins to 
recognize the bottle and to hold out its hands for it. 

Many mothers worry because they think their 

19 



CARE AND FEEDING OF THE INFANT 

babies are cross-eyed. The eyes of the new-born 
are inco-ordinated. One eye may be closed, one 
open; one may be in motion and the other remain 
perfectly still. Co-ordination and fixation develop 
at the third month. A squint is apt to be present 
for the first three weeks. As the eyes of the new- 
born are particularly sensitive, they should be pro- 
tected from too much light, and the room, for the 
first few days, must be darkened. It must not 
be forgotten that the new baby is accustomed to 
darkness. 

Although a baby cries at birth there are no 
tears until the end of the third month. 

In connection with the tears it may be well to 
mention the smiles. The first one appears about 
the eighth week. What appears to be a smile earlier 
than eight weeks results from abdominal colic. 

Hearing 

Directly after birth the babe is stone deaf. As 
soon as breathing commences the middle ear begins 
to functionate. Between the first and the second 
week it starts on clapping of hands, ringing of 
bells and slamming of doors. It does not turn its 
head in the direction of sound before the second 
month. Voices of parents are recognized between 
the third and fourth months. 

These points are important, as it often is pos- 
sible to tell within the first six months whether 
an infant is mentally deficient or not. 

Speech 

From the third month on the infant indulges in 
its own first unintelligible attempts at talking. This 
takes the form of definite words about the first 
year. Mamma and Papa or Da Da are usually the 
first ones, then a few nouns and names of things. 
Before the second year is up simple words are put 
together and verbs and short sentences are ac- 
quired. 

20 



DEVELOPMENT OF THE INFANT 

If the child does not speak by the end of the 
second year the tonsils and adenoids should be 
looked into, and the child examined for signs of 
mental deficiency. Normal children may not talk 
for six months or a year later. 

Sleep 

Twenty hours of sleep should continue for the 
first six or eight weeks. After that time the infant 
does not sleep so much, but should average six- 
teen hours for the first year, at least a two hours' 
nap in the morning and two in the afternoon, in 
addition to a good twelve hours' sleep at night. 

Towards the end of the first year it sleeps less, 
one hour in the forenoon and one in the after- 
noon. If the infant cries when it should be asleep, 
it is probably wet, hungry, overfed or colicky, has 
cold extremities or the clothing is too tight or 
irritating. 



21 



CARE OF THE NEW-BORN 
BABE 



CARE OF THE NEWBORN BABE 

A fter the physician is convinced that the new- 
Z\ born babe is physically able to combat with 
JL** its new surroundings, it should be handed 
over to the nurse. The nurse should see that the 
cord has been properly tied and that there is no 
oozing of blood, and that it cries sufficiently to 
fully expand the lungs. 

Care of the Eyes 

The eyes should be attended to at once. First 
irrigating them with a boric acid solution. A medi- 
cine dropper can be used for this purpose. The 
physician can hold the eyes open and the nurse 
drop the solution; this should be followed up with 
five per cent protorgal or one per cent silver nitrate 
solution. The latter is not so good, as it is irri- 
tating. 

Care of the Vagina 

Great care should be taken of the genitalia of 
the female babies, especially in cases where the 
mother has been infected previous to labor. The 
lips of the labia should be separated, the parts 
sponged from above down with boric acid solu- 
tion and a drop or tw r o of five per cent argyrol 
left between the parts. Quite frequently in per- 
fectly normal female babies there is a slight vaginal 
discharge which persists for several days, but dis- 
appears on treatment with boric acid. 

Care of the Cord 

The stump of the cord requires careful atten- 
tion, not only to hinder haemorrhages, but to pre- 
vent infection. As soon as possible after it is cut 
it should be dressed. The vernix caseosa, wher- 
ever it would come in contact with the bandages, 
should be wiped off with steril albolene or vaseline. 
The stump should then be surrounded with steril 

25 



CARE AND FEEDING OF THE INFANT 

gauze and around this the steril bandage should be 
put. Keeping it steril and dry promotes healing. 
To this end the baby is given only sponge baths 
in the lap of the nurse until the cord has separated. 
The nurse should wash her hands carefully before 
touching the baby and she should not allow the 
band to become wet or moist. If possible the 
dressing should not be changed until the cord 
drops off — providing there has been no infection 
this will occur at the end of five or six days. At 
no time should it be twisted to see if it is ready 
to drop off. There is always danger of starting 
a haemorrhage. During the first hours after birth 
the nurse should observe the dressings frequently 
to see that they are not stained with blood, as 
quite frequently it happens that the cord has been 
insecurely tied, the knots slip, and it continues 
to bleed. 

After the cord has separated it requires a week 
or so before the navel is completely healed and 
during this time the nurse cannot be too careful. 

Sponging and Bathing 

As before mentioned, until the cord drops off 
it is absolutely necessary to keep it dry and steril. 
On this account the complete tub bath is contra- 
indicated until after the sixth day, when the cord 
shrivels up, and usually drops off. At the time of 
birth the body is covered with vernix caseosa, a 
fatty greasy mass, and is stained with blood and 
meconium, etc. The vernix caseosa does not yield 
readily to water, so it is advisable to anoint the 
body with steril albolene or steril vaseline and then 
rub it off with cotton. After this cleaning process 
the baby should be dressed and wrapped in a blanket 
and put in a warm bed with a hot water bottle near 
it, as these infants must be kept sufficiently warm. 
Before birth they have been surrounded by an even 
body temperature and until they become accus- 
tomed to their new surroundings it is necessary to 

26 



CARE OF THE NEW-BORN BABE 

supply artificial heat. The babe, exhausted from 
birth and severe handling, sleeps almost continu- 
ously for the first twelve or fifteen hours, and dur- 
ing this time it should not be disturbed. 

When the infant awakens it should be given 
the first sponge bath, preferably in the morning, 
on the lap of the nurse. To avoid chilling, the 
water, soap and freshly-aired clothing should be 
prepared before the infant is undressed. The tem- 
perature of the room should be at least 70° F. 
The temperature of the water should be above that 
of the body, at least 100°. The eyes should be 
first swabbed out with a pledget of cotton dipped 
in boric solution. A separate dish should be re- 
served and a fresh piece of cotton used for each 
eye. Care should be taken to note any infection. 
Under no consideration should the mouth be washed 
out. After the eyes have been attended to, the 
ears, face and head should be sponged. The water 
used on the body should not be used on the face. 
A separate basin and sponge should be reserved 
for the face and head. A good mild soap, like 
Castile, should be used. The baby should be un- 
dressed, except for the band, and the body washed 
piece-meal, the other parts being protected by a 
blanket so that it does not become chilled. All 
the creases should be washed thoroughly. The 
genitalia of the female babies should be sponged 
from above down, with a pledget of cotton and 
boric solution. During the bath care must be taken 
that the cord does not get wet, or even damp. 
Under no circumstances should the dressing be 
touched. If the band gets wet it should be changed 
for a steril, dry one. The bands must be kept 
absolutely dry and steril. Not only should they 
be washed and boiled, but after drying they should 
be pressed with a hot iron, which aids in destroy- 
ing bacteria. 

When the cord drops off the navel should be 
watched to see that it heals. It should be treated 

27 



CARE AND FEEDING OF THE INFANT 

daily with a drying powder like dermatol, and 
a fresh band applied. If there is any odor from 
the stump, or if it does not properly heal and a 
granuloma forms, a physician should be notified 
and energetic treatment inaugurated. An infection 
through the cord is the most dangerous complica- 
tion we have to deal with. Usually after a month 
or six weeks the band can be discarded. Wearing 
a band too long tends to weaken the abdominal 
muscles and to keep it in place it has to be ap- 
plied so tightly that it interferes with comfort and 
digestion. It should be removed gradually, a strip 
being torn off daily. If the infant is very thin 
and there is no adipose tissue to protect the viscera 
it is advisable to wear the band a longer time, as 
chilling predisposes to diarrhoea. 

The Bath 

As soon as the cord has separated, usually on 
the fifth or sixth day, a complete tub bath should 
be given, preferably in the morning before the 
first nursing or feeding period. If this seems im- 
practical it can be postponed until the time of the 
second feeding. 

As an infant is very susceptible to drafts and 
chilling, the doors and windows should all be 
closed before the baby is undressed. The tub 
should be placed before an open fire, and if there 
are drafts, surrounded in part by a screen. 

The temperature of the room in the first few 
weeks should be between 68° and 70° F. A com- 
plete set of clothes, properly aired and warmed, 
should be near at hand ready to slip on. 

The best tubs are the metal ones or the fold- 
ing rubber ones. They should be kept scrupulously 
clean and used for no other occasion than bathing 
the infant, never for laundry purposes or as a 
receptacle for soiled linen. 

During the first few weeks the temperature of 
the water should be above body heat 100° to 101° F. 

28 



CARE OF THE NEW-BORN BABE 

After the first six or eight weeks the baby should 
be accustomed to a temperature of 97° or 98° F. 
and towards the end of the first year 92° to 94° F., 
and at two years 89° to 90° F. The temperature 
should be regulated with a thermometer, never by 
the hand. Most hands are accustomed to very hot 
water and there is danger of immersing the in- 
fant in too hot water. If there is no thermometer 
at hand the nurse should test the water with the 
bared elbow; if it feels too warm for the elbow 
it is too warm for the baby. 

Some nurses prefer to lather the infant with 
soap in the lap and then dip it in the bath water 
and sponge it clean. It always seems that an in- 
fant gets unnecessarily exposed and chilled this 
way and that it is better to do all the sponging, 
soaping, etc., in the tub. 

Separate pledgets of cotton and a special bowl 
of clean water should be used for the eyes; in the 
first days a boric acid solution is advisable. The 
baby's face should not be washed in the same water 
in which the body is washed, and separate sponges 
should be reserved for face and body. The reason 
for this is obvious. 

Castile soap or some mild and pure soap is to 
be preferred. During the bath the baby should be 
immersed up to the neck, the nurse supporting it 
in a sitting position with her left hand under the 
left shoulder, grasping the left arm, with the baby's 
head resting against her forearm; the right hand 
is then free to wash the infant. First the head 
and hair should be soaped and washed off; then 
the body, taking care that all the little creases, 
axilla, neck and ears are carefully sponged. It is 
not advisable to follow up the warm bath with 
a cold sponge. Infants have not enough resistance 
for cold water. The baby should not remain longer 
than three to five minutes in the bath; a prolonged 
one is weakening. 

29 



CARE AND FEEDING OF THE INFANT 

As the infant grows older and crawls about the 
floor it is advisable to give the daily bath at bed- 
time. At any rate, it should be sponged before 
being fixed for the night. 

The bath completed, the baby should be en- 
veloped in a crash towel, previously warmed, and 
dried more by patting the towel than by rubbing 
the babe, as the new skin is very tender and easily 
chafed; when it is as dry as possible, it should 
be powdered with zinc sterate or unperfumed 
talcum powder; especial emphasis being directed 
against all the creases, the axilla and the groins. 
Care must be taken with female babies that the 
powder does not collect between the labia; it is 
apt to set up irritation. A pledget of cotton dipped 
in the talcum affords the most satisfactory means 
of powdering. It can be used once and thrown 
away; the puff is unhygienic, being used to powder 
genitalia, buttocks and body. 

Insufficient drying is dangerous to the infant. 
Not only is the skin irritated, but a damp skin pre- 
disposes to contracting a cold. 

The ears need especial attention, and should be 
dried out with a blunted toothpick about which a 
pledget of cotton has been wound, so that the 
delicate drum-membrane is not injured. 

The nose is cleaned in the same way. It is im- 
possible to nurse when it is stopped up, so the 
nostrils should be kept clear, with a cotton appli- 
cator smeared in vaseline. 

The nails should be cleaned with a blunted tooth- 
pick and kept short to keep the infant from scratch- 
ing itself. 

After the bath and the powdering, the navel 
should be properly bandaged and the infant 
dressed, put in bed and given its feeding and 
allowed to take the morning nap. 

As for the mouth it should never be cleaned. 
Old nurses have a habit of swabbing it out with an 

30 



CARE OF THE NEW-BORN BABE 

index finger around which a pledget of gauze or 
cotton, dipped in boric acid solution, has been 
wound; the tender mucus membrane is easily excori- 
iated and a stomatitis or thrush results. At best 
this mouth cleaning has no significance as an infant 
has not any teeth about which food remains might 
collect. When the teeth have made their appear- 
ance they should be cleaned once a day with a soft 
rubber tooth brush. The brush must be kept scrup- 
ulously clean and boiled before being used. 

The Baby's Room 

The room for the baby should be the airiest, sun- 
niest, and pleasantest room in the house. It should 
be on the sunny side with an eastern, southeastern 
or southwestern exposure. A corner room with 
windows facing east and south or a southwest room 
are the most satisfactory. Above all the room should 
be dry and not too well shaded by trees and it 
should have windows sufficient to afford plenty of 
light and fresh air. One window should always be 
open and if there is a draft the bed should be sur- 
rounded by a screen. Light is just as important as 
air and a deficiency is said to predispose to nodding 
spasm or Spasmus Nudans. 

For a new-born babe the room temperature should 
be between 68° and 70°; after two or three months 
64° to 66°. During the night it should not be allowed 
to get cooler than 58° or 59°. It is not good to get 
the child accustomed to too warm a room as a hot 
stuffy atmosphere predisposes to nasal catarrh and 
bronchitis. 

As soon as the infant is old enough it should 
sleep in a room alone. The apartment where the 
baby sleeps should never be used for cooking, wash- 
ing or ironing as a damp atmosphere is extremely 
unhealthy. 

The furnishings should be of the simplest. 
Everything should owe its presence to utility and 

31 



CARE AND FEEDING OF THE INFANT 

never to ornamentation. White furniture is the 
most appropriate as it can be readily cleaned with 
antiseptics when the occasion arises. A white 
enameled iron or brass bed, with high sides, a 
bureau, a table and a couple of chairs are all that 
are necessary. 

The curtains should be of the simplest without 
any draperies or hangings; everything and any- 
thing which is apt to collect dust should be avoided. 
No upholstered furniture should be countenanced. 
A wooden polished or painted floor is the most 
hygienic. This proves satisfactory for the infant 
in arms, but not for the child beginning to crawl 
and walk when it is apt to be dangerous; a rug can 
be used then. The walls should be painted or 
simply papered. 

On account of ventilation it is well to have a fire- 
place in the room. When impossible, a stove in 
preference to a gas or oil burner. 

None of the furniture should have sharp cor- 
ners or projections, with which the toddling young- 
ster might come in contact. 

The artificial lighting should be electric and so 
arranged that it does not flare in the baby's eyes 
when turned on at night. 

The room should be well ventilated; one window 
always open winter and summer, day and night, and 
two or three times during the day the babe should 
be taken into an adjoining one while all the win- 
dows are opened and the room well aired out. This 
should be done for the last time just before the 
infant is put to bed for the night. 

When the infant sleeps the room should be abso- 
lutely quiet. Waking it up by loud talking or un- 
seemly noises in the adjoining apartments predis- 
poses to the making of a nervous child. 

When the baby is old enough to sit, a little stall 
should be supplied; here the infant is protected and 
can exercise its limbs freely by kicking and rolling 

32 



CARE OF THE NEW-BORN BABE 

around and soon learns to stand upon its feet and 
to take the first faltering steps. 

The room should never be swept or dusted when 
the infant is in it. All cleaning should be done with 
a damp cloth and a carpet-sweeper. Plants and 
flowers are best avoided. 

The Bed 

The bed is the most important article of furni- 
ture in connection with the baby. If possible it 
should be in a room by itself and so placed that 
there is no chance of draft between doors or win- 
dows; if this is impossible it should be protected by 
a screen. 

The most satisfactory beds are of enameled iron 
or brass. They are easily kept clean. The sides 
should be high, one arranged so that it is lowered 
or raised at will. It should be well off the floor so 
that no draft sweeps across it. 

The sides should be lined, especially for a new- 
born babe. The mattress should be of hair and firm 
so that the youngster does not sink into it. Feather 
mattresses are a bad practice, because they keep the 
infant too warm and there is no chance of evapora- 
tion so that the body is continually bathed in per- 
spiration, which predisposes to different forms of 
skin eruptions. The new-born babe does not need 
a pillow; as it grows older one of hair should be 
supplied. The feather pillows are bad for the same 
reason that feather mattresses are. A perspiring 
head predisposes to furunculosis. 

The infant's position should be frequently 
changed. It should not be allowed to sleep too 
long on one side; a change tends to make the head 
symmetrical; lying too long on one side tends to 
produce a flatness; it is necessary to be especially 
careful in Rickets. 

A thin rubber sheet should cover the mattress to 
keep it from getting soaked with urine. 

33 



CARE AND FEEDING OF THE INFANT 

A baby's bed is made up like other ones. In cold 
weather the sheets should be warmed with a hot 
water bottle. The under one should be of cotton, 
the upper a thin woolen one. Except in the first 
few days the infant should not sleep between the 
folds of a blanket. When the baby is fixed for the 
night the clothes should be pinned in place on either 
side, then there is no danger of taking cold from 
becoming uncovered. 

In summer the bed and baby buggy should be 
protected from insects by a piece of netting. It 
should be out of the baby's reach and should not 
interfere with the circulation of air. 

Canopies and curtains should be done away with. 
They cut off the supply of fresh air and collect dust. 

A rocking cradle gets the infant in bad habits; a 
baby goes to sleep just as well without motion of 
any kind. Rocking and trouncing after eating often 
cause regurgitation of food. Moreover once this 
practice is begun it is hard to break. All that a 
baby desires to go to sleep is a full stomach, dry 
diapers, a warm dry bed, a supply of fresh air and 
absolute quiet. 

When it is impossible to buy an iron bed a lined 
clothes basket with a comforter for mattress serves 
the purpose just as well. The basket, on account of 
draft, should not rest upon the floor; the top of a 
steamer trunk serves as a good pedestal. I know of 
one poor mother who could neither afford bed nor 
basket and who used a deep bureau drawer propped 
up on two chairs. The child slept in this impro- 
vised bed for weeks and thrived. Two infants 
should not sleep in the same bed, and the babe 
should never sleep with the mother. Too many 
worn out and tired out mothers have rolled over 
and suffocated their sleeping infants. 

Where there is more than one baby in a family 
they should sleep in separate rooms if possible, as 
the one frequently disturbs the rest of the other. 

34 



CARE OF THE NEW-BORN BABE 

Baby Clothes 

The infant's clothes are intended to keep the 
body warm and should be chosen with this in mind. 
They should be as simple and as loose as possible 
and there should be a plentiful supply. Improper 
and inappropriate clothing does harm. If too warm 
there is no chance of evaporation; the body is con- 
tinually bathed in perspiration, the baby is pale 
and listless and the musculature weak. It does not 
gain in weight and is predisposed to colds and skin 
eruptions. If too tight and the infant is wrapped 
up like a mummy the digestion, blood circulation, 
respiration and the full play and development of 
arms and legs is interfered with. Too tight cloth- 
ing can cause vomiting. Often doctors and parents 
are in a quandary over a crying baby, but it imme- 
diately ceases as soon as its clothes are removed 
and it is wrapped in a blanket. It is just as injuri- 
ous not keeping a baby warm enough. Too great 
cooling predisposes to diarrhoea. All infants are 
susceptible to heat and cold, and should be dressed 
according to the season. When the weather is hot 
the diaper and a shirt are all that are necessary. As 
the weather grows colder, other clothes are added. 
A good guide as to whether the infant is properly 
clothed, is to feel the feet; if they are cold and 
clammy the infant is insufficiently clothed. Cold 
feet are the chief cause of indigestion, colic, hic- 
coughing and fretting. 

It is better to avoid pins and safety pins in 
dressing. They are apt to become unclasped and 
stick or scratch the infant. Tapes are the most 
suitable means of keeping the clothing together. 
After the infant is dressed, and often during the day 
the clothes should be pulled out and straightened. 
Folds and wrinkles interfere with its comfort. 

New clothes should be washed and boiled before 
being used, not only because they are stiff and 
starchy, but to avoid any chance of infection. 

35 



CARE AND FEEDING OF THE INFANT 

They should be laundried soft so that there is 
no chance of scratching or chafing. New flannel is 
particularly irritating and should be examined care- 
fully for rough ends. All clothes before being used 
must be thoroughly dried, aired and ironed. Iron- 
ing helps to destroy bacteria. A flannel band is 
necessary when the cord drops off; none is required 
after the first month. If one is desired linen mesh 
can be used. Wearing a band too long prevents 
the complete development of the abdominal muscles. 

The following list of garments are recommended 
and advisable for the infantile outfit: 

6 flannel binders (1% yards long — 4 inches 
wide). 

6 shirts — wool, wool and silk, or cotton. 

6 inside shirts with or without arms — cotton, 
silk, or thin silk and wool. 

6 "Gertrude" pinning blankets with shoulder 
straps — open down the front. 

6 pair of knitted socks. 

3 pair worsted booties. 

6 muslin or cotton petticoats. 

6 white muslin slips. 

3 dozen linen diapers (25x50 inches). 

3 dozen congress material or thick cheesecloth 
diapers (22x44 inches). 

1 knitted jacket 

1 flannel jacket 

2 caps — one thin, one thick. 
1 cloak. 

12 bibs. 

1 pair mittens. 

1 knitted blanket. 

When the child begins to crawl on the floor the 
clothes should be loose and shortened; rompers are 
then advisable. Soft leather booties should take the 
place of the knitted ones, and long socks. The half 
silk socks are a bad practice except in climates 
where the children can stand to have two-thirds of 

36 



CARE OF THE NEW-BORN BABE 

their little legs exposed to the raw air. Many chil- 
dren have been lost in the hardening process. 

When the infant begins to walk shoes instead of 
booties should be worn. The shoes help to support 
the ankles. 

The Diapers 

The diapers are the most important appendage 
of the baby's wardrobe, and there should be a plen- 
tiful supply of scrupulously clean ones always on 
hand. It is easy for a mother to calculate the num- 
ber when she realizes that the new-born infant soils 
about twenty in twenty-four hours, and as long as 
the baby remains on a fluid diet the number does 
not diminish materially. Old linen makes the best 
ones. If the material is new it should be washed 
and boiled for fifteen minutes before being used. If 
not it is too stiff and fails to absorb properly, the 
urine runs off and its mission fails. For the new- 
born two diapers should be used, an inner one made 
of some soft, easily absorbable material which col- 
lects all the excreta and an outer one of linen. If 
desired during the first few weeks a square of old 
linen six by four inches can be used. This fits in 
the inner diaper, is not at all bunglesome and after 
being soiled can be thrown away. This is a very 
practical method and saves much work in the laun- 
dry. Arnold manufactures a very praiseworthy 
one; it is about the size of a wash cloth and made 
of a peculiar knitted material which absorbs very 
readily. It is used in connection with the inner 
diaper; they are easily laundried. 

When the infant reaches the age of eight or ten 
weeks it is advisable to put a thin piece of rubber 
sheeting between the folds of the inner diaper. It 
saves the baby's clothes and bed linen from being 
continuously soaked. One should be careful that 
the rubber does not come in contact with the skin. 

Before being used the diapers should be warmed 
through. A good practice is to keep a set properly 

37 



CARE AND FEEDING OF THE INFANT 

folded ready for use, warmed about a hot water bot- 
tle. In this way when it is necessary to change, the 
infant does not receive a shock from a cold one. 

A diaper ready for application is three cornered; 
the thin inner one is first firmly and smoothly fas- 
tened about the infant's body, the third corner being 
brought up between the legs. Then the outer one is 
similarly put in position. It is not necessary to 
bring the third end of the outer diaper between the 
legs. It makes it very bunglesome, especially with a 
young infant. This end may be left free. It must 
not be so tight that it hinders digestion or chafes 
the baby's legs or prevents their free motion. It is 
better to pin it firmly in position than to knot or 
twist the ends. The knots and twists often prove 
uncomfortable. 

Above all it must not be voluminous, as a too 
bunglesome one between the legs is said to pre- 
dispose to their bowing. 

Woolen and flannel diapers are absolutely to be 
avoided. They are too clumsy, keep the baby 
too warm and prevent evaporation of moisture. It 
is important that as much moisture as possible evap- 
orates and that the warm urine does not soften and 
irritate the tender flesh. 

At best the diaper with its many folds and pins 
hinders the free motion of the infant. It is an art 
so to arrange it, that it is not too tight and still 
not so loose that it is easily kicked off and hobbles 
the small legs. 

Once a day for about fifteen minutes the baby's 
room being comfortably warm, the clothes, with 
the exception of the shirt, should be removed and 
the infant allowed to kick its legs and stretch 
freely. 

Further, it is important to remember that when 
a diaper is wet it is not to be dried and re-used as 
it is irritating to the tender skin of the baby. The 
soiled diapers must be laundried before being ap- 

38 



CARE OF THE NEW-BORN BABE 

plied again. Simply washing in hot water and soap 
is not sufficient; they must be boiled for fifteen 
minutes, thoroughly aired, dried and ironed. A 
good non-irritating white soap should be used. 

Soiled Diapers 

The soiled diapers must not be kept in the room 
with the baby. They should be placed in a cov- 
ered pail and kept on a back porch, or in a handy 
storeroom. They should be roughly washed out 
as soon as possible and kept soaking in clean cold 
water, until they can be thoroughly washed in hot 
water and soap and boiled. 

Changing of Diapers 

A new-born babe and even up to six or eight 
months, passes its urine about eighteen times in 
twenty-four hours, more often during the day and 
after nursing, and has two to three stools in that 
time. 

Theoretically, the infant should be changed as 
often as it wets, practically this would be a mis- 
take, as it would have no opportunity to sleep. A 
well fed and thriving baby sleeps directly after the 
bottle from one to two hours and it is best to leave 
this sleep undisturbed. Directly before the nursing 
or feeding time it should be put in dry diapers and 
properly powdered. It is a bad practice to change 
after nursing. The infant is sleepy then and at 
this time it vomits and regurgitates very easily 
on being handled. After nursing or the bottle 
it should be laid quietly in bed. If, after an hour, 
it awakens crying and appears uncomfortable the 
diapers should be changed. On an average ten 
changes in twenty-four hours generally prove suffi- 
cient for its comfort. It is only advisable to awaken 
it to change its diapers when the buttocks and parts 
are tender and excoriated, as wet diapers tend to 
aggravate the condition. 

39 



CARE AND FEEDING OF THE INFANT 

As too frequent sponging makes the skin sensi- 
tive it is not necessary to wash the parts after each 
wetting, unless the condition such as chafing, war- 
rants it. Usually drying and a light powdering are 
sufficient. As before mentioned it is a bad practice 
to put the powder on too thick, it leads to bad 
results especially with girl babies, when it is apt 
to collect under the labia and start up an irritative 
process. 

When the baby has had a stool, the diapers 
should be changed immediately, and the buttocks 
and between the legs sponged with warm water. 
Care must be exercised with female babies to w r ash 
them from before backward, as there is danger of 
intestinal bacteria entering the urethra and so ex- 
citing a cystitis or pyelitis. 

After a proper cleansing the parts should be 
lightly powdered and the baby rediapered. 

An unscented talcum or zinc powder is the best 
to use. 

Night Clothes 

The diapers should be the same as during the 
day. At first the two little shirts should be changed 
for two other similar ones. Later, only one under- 
shirt is necessary. Linen mesh proves the most 
satisfactory. Over all the infant should wear a 
long night-gown. In warmer climates, for older 
children, one of cotton affords sufficient warmth. 
For very young and new babies and in cold climates 
cotton flannel is the most satisfactory. 

The hem should be made with a drawstring; 
this protects the feet from becoming exposed and 
getting cold. A night cap is unnecessary. The 
greatest care should be taken that the infant does 
not get chilled in changing its clothes. They are 
very susceptible to chilling; on this account all 
changing of clothes, and especially of diapers 
should be as rapid as possible. It expedites mat- 

40 



CARE OF THE NEW-BORN BABE 

ters, particularly during the night, if the diapers 
and clean night shirts are all ready to slip on. 

The Baby Buggy 

The buggy is about as important as the bed. 
In fact many infants sleep entirely in their buggies. 
At any rate they spend a good part of each day 
therein. 

The best ones are of wicker. They permit the 
circulation of air better than the wooden leather- 
lined ones. The buggy should be 90 cm. long, 45 
cm. wide and 35 cm. deep. The head should be as 
deep as the foot so that there is no danger of the 
infant rolling out. The gondola-form and the half- 
wagon are not to be recommended, because the 
baby lies too exposed and there is danger of draft. 

For the lining some kind of cloth is more suit- 
able than leather, as the latter is heating and pre- 
vents all circulation of air. The mattresses, covers, 
etc., should be arranged as in a bed. 

The buggies which are suspended by springs 
are awkward as there is a possibility of pitching the 
youngster out on striking an obstacle. 

Continuous shaking and rocking is a bad prac- 
tice. It encourages a habit which is to be avoided. 

The top should be lined with blue, gray or 
green; all these shades exert a good influence on 
the eyes. White reflects light and is irritating. 

Curtains hanging from the top defeat the pur- 
pose of giving the baby an airing; they keep the air 
out. Nothing in the shape of a ball or rattle should 
be allowed to dangle from the top in front of the 
baby for the purpose of entertainment. The infant 
tries to fix the eyes on the dangling object and so 
a squint develops. 

As the baby grows older it is necessary to have 
a strap about the body, connected to the buggy, then 
there is no danger of its pitching out when it is left 
for a moment. 

41 



CARE AND FEEDING OF THE INFANT 

Kissing 

Most mothers nowadays realize the danger of 
promiscuous kissing of infants. It is the most 
plausible and probable way of spreading infection, 
especially tuberculosis and throat affections. All 
kissing should be prohibited, and that allowed 
should be confined to the back of the neck. Kissing 
the hands is just as objectionable, as they are con- 
tinuously coming in contact with the mouth. 

Lifting 

As the infant is incapable of supporting its own 
head one should always be careful to slip one hand 
behind the head and neck before picking it up. 
This is best accomplished by raising the legs with 
the right hand and slipping the left one under the 
body to the head and shoulders. Then the infant 
can be lifted and supported on the left arm. It 
should never, before the fourth month, be taken up 
by grasping it under the arms; after the baby is able 
to support its head, this is the best place to take 
hold; it should never be raised by taking the wrists. 
It is very easy to dislocate the joints or cause a 
separation between the head and shaft of the bone. 

Throwing the baby into the air and catching it 
is a mistake; it is apt to fall or the ribs be fractured 
by rough handling. 

Carrying 

The infant should be carried first on one arm 
and then on the other, never entirely on one, other- 
wise it gets into the habit of using one hand and 
arm almost entirely, and the other does not properly 
develop. 

The infant also gets into the habit of holding 
its head and body in one position which frequently 
develops into deformity. Until after the sixth 
month it should never be carried without support- 
ing the back. 

42 



CARE OF THE NEW-BORN BABE 

Weighing the Baby 

During the first year the infant should be 
weighed twice during the week and a record kept 
in a book. Daily weighing has little significance. 
The most convenient time is in the morning imme- 
diately before the bath, when it is stripped. It 
should always be done at the same time and under 
the same conditions, otherwise it has little value. 
If desired, the baby can be weighed in its clothes, 
then a duplicate of the garments weighed, and sub- 
tracted to get the exact weight of the infant. 

The scoop of the scales should be covered with 
a small crash towel of known weight and both 
should be previously heated with a hot water bottle 
before the naked baby is put on, otherwise the cold 
metal is a shock. 

Care of the Ears 

The mother or nurse should not allow the infant 
to sleep with its ear doubled under. Such a prac- 
tice, persisted in, results in the ears growing straight 
out. To prevent this from occurring, the infant 
should w T ear a cap of tape or net to keep the ears 
close to the head; or bands of adhesive plaster 
should be applied. Care must be taken with the 
latter method, that the ears do not become irritated. 
The bands of adhesive can be removed with ben- 
zine. 

Care of Premature and Weak Infants 

Premature babies are those infants born before 
nine months of pregnancy have expired. 

Weak infants are abnormally small twins or the 
offspring of parents suffering from some chronic 
disease as syphilis or tuberculosis. 

All of these infants have an abnormally low body 
weight. A normal full term baby weighs seven to 
seven and one-quarter pounds. These premature 
and weak ones often weigh less than four pounds. 

43 



CARE AND FEEDING OF THE INFANT 

A number of cases are on record which were saved 
and which weighed between two and three pounds. 
The percentage of deaths is very high. 

Also all of these infants have a tendency to sub- 
normal temperature. It is impossible for them to 
keep up their own body heat. On this account it 
has to be supplied artificially, as the greatest danger 
lies in their becoming chilled. The temperature of 
a normal infant is between 98° and 99° F.; of pre- 
mature infants around 95° and 96° F. It is neces- 
sary, therefore, to protect them from giving up 
their body heat and to supply it artificially. The 
latter can be accomplished with earthenware bottles 
filled with hot water, or hot sand. The bottles 
should be placed in the bed, one on either side of 
the infant, and one across the foot of the bed. They 
should be changed every hour. The temperature 
of the room should be at least 70°. 

To prevent the loss of heat the body should be 
smeared lightly with vaseline, and then the infant 
enveloped in cotton, from head to toe, only the face 
being exposed. If desired the clothes may be put 
on over the cotton covering. These infants should 
be kept in a warmly lined bed, preferably with a 
pillow for mattress. 

When possible an incubator should be procured. 
It serves three purposes: 

Provides an even temperature. 

Supplies and prevents loss of body heat. 

Protects the infant from infection. 

The lightest infection is disastrous, and they 
must be protected from head-colds, bronchitis, etc. 
An incubator is dangerous in that it requires con- 
stant attention to prevent overheating which usually 
results disastrously. 

The supply of fresh air must be regulated and 
precaution taken that it does not get dried out, by 
supplying a small cup filled with water which can 
be attached to the side of the incubator. 

44 



CARE OF THE NEW-BORN BABE 

Feeding of Premature and Weak Infants 

The feeding of these premature babies is a 
problem. 

1. They have an abnormal tendency to sleep. 
They do not awaken at meal times like normal 
babies, and when they are awakened, they go to 
sleep again almost immediately, without taking 
their food. 

2. They are too weak to suck on the breast. 
The milk has to be expressed and the infant fed 
either with a spoon, pipette or by gavage. 

To save these babies breast milk is almost an 
absolute necessity. Where it is impossible to obtain 
an adequate supply it is necessary to resort to a 
whey cream mixture. 

On account of the inco-ordination of the central 
nervous system and lack of development of the 
respiratory center, these premature infants are in 
constant danger of sudden death. They suddenly 
cease to breathe and become blue. At best breathing 
is superficial. Oxygen should always be kept at 
hand for these attacks, and w T hen the nurse notes 
that the infant is cyanotic and blue, she should do 
everything in her power to stimulate respiration by 
spanking, sprinkling cold water in the baby's face, 
pinching the cheeks, artificial respiration, etc. 

If the infant has one such attack, they are likely 
to have others, and require constant attention. They 
are also predisposed to spasmophilia and convul- 
sions. 

It is also necessary to be very careful in bathing 
these infants. The temperature should be at least 
101° to 103°. All unnecessary cooling and exposure 
should be avoided. 

Treatment of Asphyxia 

Often it is difficult to get the new-born babe to 
breathe. In these cases the nurse should clean the 
mucus from the throat with a piece of gauze 

45 



CARE AND FEEDING OF THE INFANT 

wrapped about the index finger; then the infant 
should be held aloft by the feet to give the mucus, 
liquor amnii, etc., a chance to escape. 

If these measures do not succeed in producing 
respiration, it is necessary to resort to stimulation 
and artificial respiration. 

Stimulation is best administered by slapping the 
baby on the buttocks or on the soles of the feet or 
vigorous rubbing of the body with a towel, blowing 
in the baby's face or sprinkling it with cold water. 
One author suggests tickling the nose with a feather. 
In many cases this produces loud crying and breath- 
ing begins. 

If this is not successful, stronger stimulation is 
necessary. The infant should be alternately dipped 
in ice water, then taken out and dipped in hot water. 
It may be necessary to repeat this procedure sev- 
eral times. 

If this is not successful, it is necessary to resort 
to artificial respiration. There are several methods : 

1. Mouth-to-mouth insufflation. The child's 
head is extended and the mouth covered with gauze 
and the physician expires or blows forcibly down 
the infant's throat. Quite often this succeeds in in- 
ducing crying and so, breathing. 

2. Another method is to support the infant's 
back with one hand, and taking the legs in the other, 
bend the body back and forth at the hips so that 
the legs approach the chest. It is necessary, often, 
to repeat this many times. 

3. Schultze's swinging method. The infant is 
held in the physician's or nurse's hands, face to 
front, thumbs over shoulder, index fingers in axilla 
and the rest of fingers supporting the back. The 
child is then swung alternately between the knees 
and over the head, flexing the head upon the chest 
in the latter position. 

4. A simple method is to lay the infant on a 
table, face up, then with both hands to press the 
chest rhythmetically. 

46 



INFANT FEEDING 



INFANT FEEDING 

Breast Feeding 

There is only one food intended for the 
new-born babe, and that nature supplies in 
mother's milk. For nine months previous to 
birth the placenta provides, by means of the blood, 
whatever nourishment is needed for the develop- 
ing foetus, and after birth the last thing the placenta 
does is to secrete a body called a "Homone," and 
which stimulates the mammary gland to secretion, 
so that nature intends breast milk for the baby, and 
the infant's digestive powers are adapted only to 
this food. What nature supplies for the young calf 
and goat, was never intended for the delicate in- 
fantile digestion, and those who attempt to give un- 
modified cow's or goat's milk to a baby, learn this 
to their sorrow. 

Nature supplies the young of every species with 
a milk adapted to that species alone. Experiments 
with animals have shown that feeding the young of 
one with the milk intended for another ends disas- 
trously. So it is the mother's bounden duty, when- 
ever possible, to supply her infant with the food 
intended for it, and if she does not do so she breaks 
a law of nature, and whoever defies her laws pays 
for it in one way or another. Unfortunately, it is 
not only from the mother that nature exacts punish- 
ment, but especially from the infant. The baby is 
apt to pay with intestinal disturbances, and a les- 
sened resistance against infectious diseases, to say 
nothing of the conditions resulting from artificial 
feeding, such as Rickets, Scurvy, etc., and the 
mother is apt to pay by an incomplete recovery from 
her pregnancy and many times by haemorrhages. 
She becomes subject to many female complaints. 
It is a fact that a child sucking on the breast stim- 
ulates contraction of the uterus and stops bleeding. 
One author has said that mothers who have nursed 

49 



CARE AND FEEDING OF THE INFANT 

babies are not so subject to cancer of the breast 
and uterus as other women. 

Every one who has had experience with infants 
knows that the breast-fed ones are developed men- 
tally and physically far better than the artificially 
fed. At the end of one year the breast-fed baby is 
one to two pounds heavier and one-half to one inch 
longer. It is stronger and the mother's milk sup- 
plies a protecting body against infections, which is 
lacking in artificially fed infants. Statistics show 
that the breast babies are not so subject to infec- 
tious diseases, such as measles, whooping cough, etc., 
and it is a fact that one breast-fed baby dies, where 
eight bottle-fed ones succumb to one complaint or 
another. Not only does breast milk appear to im- 
munize against infectious diseases, but these babies 
are not subject to the intestinal disturbances which 
decimate our artificially fed infantile population. 

It stands to reason that breast milk is the natural 
and healthy infant food. It is manufactured in the 
breast, passing pure and fresh, at body temperature 
into the infant's stomach. There is no chance of 
its becoming infected and it requires no scientific 
modifications and consequent handling. 

Some recently published German military statis- 
tics show that not only is the breast-fed infant 
physically superior in infancy, but also during its 
whole life, and probably most important of all, the 
tie between mother and child is stronger if the in- 
fant receives its nourishment from the maternal 
breast. 

It is said that 90% of all women are able to 
nurse their babies, but only 30% are willing. The 
others cease for one reason or another, but the 
mother who gives it up because she believes that 
nursing ruins her figure, does not deserve the name. 
Some one has said that motherhood is a woman's 
most sacred and privileged calling, and the first 
duty it entails is nursing the baby on the breast. 

50 



INFANT FEEDING 

The ancient Hebrew, Greek and Roman women were 
compelled by law to nurse their babies, and were 
punished if they did not. The ancients realized 
their children received a start in life this way that 
cannot be made up in any other. Many mothers are 
forced to give up nursing on account of their work; 
to meet this contingency, several German cities have 
a system by which the mothers, who are employed 
in factories, are able to nurse their babies for six 
weeks. Their hospital expenses for that length of 
time are paid out of the Krankenkasse or govern- 
mental fund for the sick. One Berlin orphan 
asylum, where necessary, even supplies wet nurses 
for deserted infants until they are in a condition 
to be fed on artificial food. It is measures like these 
which have reduced the enormous infantile mor- 
tality. In countries where breast feeding predomi- 
nates, the mortality is much less than in countries 
where it is on the wane. For instance in Norway 
it is 8%; in Sweden 9%; in Germany, where artifi- 
cial feeding is common, it is 26% and in New York 
about 20%. It is certain that if a woman is able to 
carry a baby for nine months she is able to nurse it 
for a corresponding length of time, and it should be 
the right of every infant to suckle on the breast 
and it is the mother's duty not only to nurse her 
babe, but to do everything in her power to increase 
the quantity and quality of her milk. 

When one realizes the advantages of breast milk 
over artificial feeding, everything should be done 
to encourage the nursing mother. It is claimed that 
any well one has good milk. Nursing should only 
be given up on the advice of a physician. Fever, 
anaemia, weakness, nervousness and backache are 
not sufficient reasons for weaning. 

Contraindications to Nursing 

Tuberculosis. 

Chronic heart and kidney diseases. 

51 



CARE AND FEEDING OF THE INFANT 

Inflammation of the breast with the presence of 
pus in the milk. 

Septic diseases. 

Epilepsy, hysteria and the lesser mental disor- 
ders are not contraindications so far as the milk is 
concerned. There is no chance of inheriting char- 
acter or mental defects through the milk. The only 
danger lies in the fact that the mother might injure 
her offspring during an attack. Syphilis in the 
child is not a contraindication, if the mother has 
shown no symptoms, but the new-born infant has, 
there is no danger to the mother as she is probably 
immune. If the infant has syphilis it should not 
be put to suckle on the breast of a non-syphilitic 
wet nurse. A primary lesion of the mammary gland 
is not unknown. 

Many authors claim that there is only one contra- 
indication to nursing and that is tuberculosis. There 
have been several cases of infants who nursed while 
the mother had typhoid fever, with no untoward 
results. Measles and scarlet fever are not neces- 
sarily contraindications, unless the mother is in a 
dangerous condition. Up to six months the nursing 
infant seems to be immune to all infectious diseases. 

If a mother is ill with an infectious disease it 
takes several days before a diagnosis can be con- 
firmed. During this time the infant has been sub- 
jected to the infection and if it contracts the 
disease, it stands a better chance of recovery on the 
breast than on artificial food. 

Menstruation and Nursing 

It is said in fully one-half of nursing mothers, 
menstruation intervenes before the baby is weaned. 
It is no contraindication to nursing and it is not 
necessary to wean. Menstruation makes no differ- 
ence in the chemical constituents of the milk. How- 
ever, some authors claim that it reduces the fat and 
increases the proteid. It does diminish the quantity 

52 



INFANT FEEDING 

for a few days. In ninety per cent of the cases the 
infant shows no untoward symptoms. Sometimes 
it has a slight diarrhoea or vomits. 

Pregnancy 
A nursing mother very rarely becomes pregnant. 
When she does, it is best to wean the infant; best 
for the mother and best for the baby. The milk is 
poor in quality and the mother needs all her strength 
in the development of the foetus. However, there 
is no immediate hurry and the weaning should be 
done gradually. 

Difficulties in Nursing 

There are a number of difficulties encountered, 
both in the mother and child, which are not con- 
traindications, but demand care and attention. 

Many mothers give up nursing because their 
nipples are too small, flat or sunken so that the baby 
has difficulty in getting a grip. Many infants learn 
to nurse without the nipple and drink as one would 
from a sponge. If this seems impossible a breast 
shield can be used. 

Sometimes the breast is so hypersensitive that 
the mother cannot stand the pain resulting from 
nursing. Here the number of feeding periods should 
be temporarily reduced and the nipple treated with 
one per cent Silver Nitrate. 

Mastitis, Rhagaden and fissured breasts require 
professional attention. Weaning is unnecessary and 
uncalled for. 

On the part of the infant one of the difficulties 
encountered is weakness. Many new-born, espe- 
cially premature babies are too weak to suckle. In 
these cases the milk must be expressed and the in- 
fants fed with a medicine dropper or bottle. 

With cleft palate and hare lip it is often impos- 
sible to nurse. The milk in these cases should be 
expressed. Often it is necessary to feed by gavage 
until the misformed parts are repaired. 

53 



CARE AND FEEDING OF THE INFANT 

When an apparently normal baby refuses to 
nurse it should always be examined for inflamma- 
tion of the mouth, tonsils and pharynx. Many ap- 
parently well babies refuse the breast because it is 
painful to nurse and swallow. 

Care of the Nursing Mother 

The nursing mother should take the best care of 
herself. Everything should be made as agreeable 
and pleasant as possible. Anything upsetting the 
nervous system is apt to result in a diminution of 
the quantity or total cessation of milk. Fright, 
worry, grief, fatigue or any great excitement should 
be avoided. Emotion tends to alter the composition 
and quality of the milk and is apt to make the child 
violently ill. 

If the mother wishes to nurse her infant success- 
fully, she should live as simple a life as possible, 
avoiding all nervous excitement and eliminating all 
social engagements during the nursing period. She 
should take regular exercise daily, preferably by 
walking. Plenty of fresh air, simple food, sufficient 
sleep, rest and no worries, are the absolute require- 
ments of the nursing mother. 

The Food 

Should be as simple and appetizing as possible. 
Many mothers ruin their appetites by a too plentiful 
supply of tasteless cereals and milk. Both these 
foods are necessary, but the diet should not consist 
entirely of them and may be as varied as desired. 
Plenty of cooked vegetables and cooked fruits are 
necessary, especially as nursing mothers are notor- 
iously constipated. Meat can be eaten once a day, 
or twice in moderation. 

All highly seasoned and rich foods, salads, par- 
ticularly cabbage and onions, sour fruits, alcoholic 
drinks and strong tea and coffee should be avoided. 
Weak tea or coffee can be taken once a day, if abso- 

54 



INFANT FEEDING 

lutely necessary. Cocoa is the best beverage. Choco- 
late and a large quantity of milk are constipating. 
Sometimes it is necessary to supply fluid in some 
other form. Besides her regular meals the mother 
should drink milk when possible, especially in the 
middle of the forenoon and afternoon and at bed- 
time. Fluids tend to increase the quantity of milk. 
One glass of beer or Malt Extract sometimes acts as 
a slight appetizer. Meat, eggs and soup increase the 
percentage of fat, and a predominance of vegetables 
and farinaceous food have a slight tendency to in- 
crease the carbohydrate. Everything and anything 
hard to digest, or for which the mother has an 
idiosyncrasy, should be avoided. She should guard 
against overfeeding and constipation. To relieve 
constipation an enema or a suppository are the best 
remedies. Castor oil and calomel have a tendency 
to upset the infant. Salts decrease the quantity of 
milk. Drugs excreted in the milk which may upset 
the infant and are best avoided are : 

Castor oil, calomel, arsenic, aspirin, saly- 
cilic acid, belladonna, bromides, iodides 
and mercury, when taken over a long period 
or in large quantities. 
If it is necessary during the nursing period for 
the mother to take an anaesthetic, it is best to put 
the infant on a whey mixture for two or three days 
and then resume nursing. Alcohol in large quanti- 
ties is regularly excreted in the milk. 

Care of the Breasts 

The nursing mother should take great care of 
the breasts. They should be washed with a boric 
solution before and after nursing; then a strip of 
gauze should be put across them. The gauze should 
be renewed every day. 

The mother should expel the first milk before 
giving the breast to the baby, as it often contains 
bacteria. 

55 



CARE AND FEEDING OF THE INFANT 

Wetting the nipple with the mother's saliva be- 
fore giving the baby the breast is criminal. 

The breasts should be protected from cold and 
exposure. An extremely decollete gown should be 
avoided at this time. Chilling alters the composi- 
tion of the milk and at times upsets the infant. 

The First Nursing 

Mother and child are both exhausted after the 
birth, and both require a long, restful, unmolested 
sleep. Usually for the first twelve to twenty-four 
hours the new-born infant sleeps peacefully and 
continuously and on no account should it be aroused 
not even to be displayed by a proud parent to an 
expectant group of relatives. The infant requires 
this long sleep to get accustomed to its new sur- 
roundings. During this time it requires no nourish- 
ment and nothing to drink. If, as it sometimes 
happens, the new-born is restless, refuses to sleep 
and cries, it may be given a little boiled water. 
However, all attempts to give the infant milk in any 
form should be discouraged. It requires twelve 
to twenty-four hours to whet its appetite and to get 
up ardor for the strenuous work of nursing. Under 
no circumstances should it be put on the breast 
during the first twelve hours. The mother requires 
this time for rest, readjustment and recuperation. 

Milk first begins to appear two or three days 
after the birth of the infant; with first babies, even 
later, sometimes four or five days. If no milk has 
appeared at this time it is a mistake to think that 
the mother will have none and to cease the attempt 
at nursing. Some women, especially with their first 
babies, do not begin to secrete milk until the begin- 
ning of the second week. In such cases the infant 
should be put on the breast every period, just the 
same, as the act of sucking stimulates the produc- 
tion. If it cries and appears unsatisfied after this 
attempt, it should be given whey or an appro- 
priately diluted milk from a bottle. 
56 



INFANT FEEDING 

Colestrum 

The forerunner of milk which appears in the 
breast and which can be expressed on pressure is 
called colestrum. It is often present in the milk 
before birth and is of a deep yellow color and has 
a salty taste. In olden times it was considered 
poisonous and not given to the baby, this deduction 
being drawn on account of the peculiar taste and 
color. But colestrum, like everything else which 
nature provides, has a purpose. It not only acts as 
a food until milk begins to be secreted, but it is also 
supposed to be a mild physic. Colestrum crystals 
persist until the eighth to the tenth day, when they 
disappear. 

Milk Fever 

White, sweet milk makes its appearance between 
the second and sixth day. Sometimes much later. 
Often when the milk begins to be secreted in quan- 
tity, the breasts swell and become painful. This 
condition, which is often accompanied by fever and 
which makes the mother ill for a day or two, is milk 
fever and should not excite alarm. In earlier days 
the nurse often weaned the baby at this time, be- 
lieving the milk was not good. No greater mistake 
can be made. The sucking of the infant on the 
breast relieves the pressure, and though painful at 
times, the mother is ultimately rewarded by a plenti- 
ful supply. 

If nature intended a quantity of milk in the first 
days there is no doubt but that it would have been 
provided, but at first the infant can accommodate 
only small quantities. The amount gradually in- 
creases up to the sixth or eighth week, when a full 
liter is secreted. Many inexperienced mothers and 
nurses think this quantity should be reached much 
sooner. 

Because the infant cries once in a while is not 
a sign that it is hungry, has colic or that the milk 

57 



CARE AND FEEDING OF THE INFANT 

is disagreeing with it. During the first few days it 
is good for a healthy infant to cry and expand the 
lungs and if it does not, it should be made to do so. 
It takes some time for the infant to learn to nurse 
properly and it requires considerable patience be- 
fore the nursing progresses smoothly, but as its 
future development depends on the first few days, 
everything should be done to keep the baby on the 
breast. 

Of course in these first days before the milk 
begins to flow, the baby should not be allowed to 
hunger. For the first three or four days boiled 
water, with or without saccharin, should be suffi- 
cient, but should never be given until after the in- 
fant has first been put upon the breast. After the 
fourth day something more substantial must be given 
such as a whey cream mixture, but always the at- 
tempt upon the breast must first be made. In this 
way many an infant has been saved from being put 
upon artificial food. 

Usually the new-born babe is not given the breast 
until the second day. Both the mother and babe 
require the first twenty-four hours to recuperate 
from the birth, and their sleep and rest should be 
left undisturbed. On the second day, however, the 
first attempt should be made. The mother should 
lie on one side, her back supported by pillows, and 
the nurse having washed her hands, should prepare 
the breast for nursing, by washing the nipple first 
with boric acid and then with warm water. The 
infant is then laid in the mother's arms, not ob- 
liquely across her body, but tangent to it, the baby's 
head and chest resting across one arm. With the 
other hand the mother should place the nipple in 
the baby's mouth, at the same time being careful 
to keep the breast away from the baby's nose. It is 
impossible for it to nurse when it cannot breathe 
freely. Often it will make no attempt to suckle. 
Under these circumstances the nipple should be 

58 



INFANT FEEDING 

moved from side to side in its mouth, or the nurse 
should press the tiny cheeks together, in an effort 
to teach the infant how to suckle. Sometimes it is 
necessary to express a drop or two of milk before 
it begins to work. It is a bad practice to powder 
the nipples with sugar, before starting the nursing; 
it is apt to cause an intestinal upset. 

When the mother is out of bed, nursing should 
proceed as follows: She should sit in a low chair, 
preferably one which has no arms, one knee, by 
means of a footstool or general position, should be 
somewhat higher than the other. The infant should 
be laid diagonally across the mother's lap, the head 
resting on the mother's arm and higher knee, and 
with the free hand the nipple is held in position, 
the breast kept free of the baby's nose and a slight 
pressure is exerted which aids the infant in suck- 
ling. If the mother assumes a comfortable position 
she avoids the backache which is so frequent at this 
time. 

Method of Feeding 

In the beginning until the breasts are secreting 
an adequate amount it is necessary to give both 
breasts at each feeding, as the sucking stimulates 
the production of milk. When the baby has both 
breasts they are not completely emptied, and there 
is no stimulation to increase the quantity so both 
should be given only in the first few days. The 
last milk is the richest in fat, and completely empty- 
ing the breasts each time, increases the fat per- 
centage as well as the total quantity. 

When the baby is weak, premature or the breasts 
do not flow easily, it is necessary at first to ex- 
press the milk by hand or with a pump. Pumping 
after the baby has finished is a good practice, as 
it increases the quantity for the next period, and 
the amount pumped can be fed with a spoon. If 
it is possible to obtain an older, stronger baby 
to nurse, it increases the supply. When the normal 

59 



CARE AND FEEDING OF THE INFANT 

infant is satisfied, it goes to sleep and it should 
not be forced to take more than it wants. 

Length of Nursing Period 

The baby should not nurse longer than fifteen 
minutes. Experiments have shown that it gets all 
it wants in the first ten minutes and very little 
is obtained after fifteen minutes. If, at the end 
of twenty minutes, the infant cries and appears 
unsatisfied there is probably an insufficient supply 
of milk, and it should then be weighed before and 
after nursing to ascertain exactly how much it is 
getting. Infants who are lazy and do not work 
sufficiently should not be allowed to go to sleep 
before the first fifteen minutes are up. During the 
night the mother should not give the baby the 
breast and then go to sleep. The child may over- 
feed or go to sleep with the nipple in the mouth; 
this makes it tender and may cause fissures. 

The Amount of Feeding 

The amount of milk which an infant obtains at 
a period is variable and depends upon its age and 
development. A strong infant obtains much more 
than a w T eak one. The two first periods in the 
morning supply the largest quantity. The mother 
has had a long rest, there is a plentiful supply, and 
the baby after the night's sleep is very hungry and 
works harder. 

During the twenty-four hours of the second day 
the infant averages about two to three ounces. 

By the end of the first week about eight ounces. 

By the end of the first month about sixteen 
ounces. 

By the end of the second month twenty to thirty 
ounces. 

By the end of the fifth month thirty-two ounces. 

The total amount obtained during twenty-four 
hours can be ascertained by weighing the baby 

60 



INFANT FEEDING 

before and after every nursing and adding the dif- 
ferences together. 

A good rule for determining the requirements 
of a breast infant is the following: 

In the first quarter year, an infant requires one 
hundred and fifty grams, or five ounces for every 
Kilo, of weight (approximately two pounds) per 
day. 

In the second quarter, four and two-thirds 
ounces per Kilo, per day. 

In the third quarter, four to four and one-third 
ounces per Kilo, per day. 

The normal breast-fed baby requires in mother's 
milk in twenty-four hours one-sixth of its weight. 

Number of Feedings 

Experience and experiment have taught us that 
every three hours is often enough to give the baby 
the breast. The infantile stomach requires from 
two to two and one-half hours to empty itself, and 
then it needs a little rest before the next feeding 
period. An infant works better if it is hungry, 
and empties the breast more thoroughly, so the 
three hour rule works good for the mother and 
child. Feeding a baby whenever it cries results 
disastrously. 

A good schedule is as follows: 

Morning Afternoon 

6 A. M. 3 P. M. 

9 A. M. 6 P. M. 

12 M. 10 P. M. 

and during the first month once during the night. 
At the end of four weeks six nursing periods are 
sufficient, and the infant has a long sleep which 
gives the digestion a period of rest. Often the 
infant is able to get along with four hour periods. 
This is better still, and should be encouraged. This 
is only possible with a large supply of milk and 

61 



CARE AND FEEDING OF THE INFANT 

a strong baby. The following is a good schedule 
for four hour periods: 

Morning Afternoon 

6 A. M. 2 P. M. 

10 A. M. 6 P. M. 

10 P. M. 

When the baby is six months old, five nursing 
periods should prove sufficient. 

With premature, weak and sick infants it is 
necessary to feed smaller quantities and more often. 
This point should be left to the discretion of the 
physician in charge. 

Feeding should be done regularly and method- 
ically, even if it is necessary to awaken a child 
out of a sound sleep. Children are creatures of 
habit, and it is best to begin early with a good 
organization. At first the infant sleeps from one 
period to the next, and awakens regularly by the 
clock, just three hours after the last feeding. Of 
course, in illness, when a good rest and sleep are 
more important than a feeding, an exception can 
be made. 

It is an extremely bad habit to inaugurate the 
custom of feeding twice during the night; merely 
because the infant cries out once or twice is no 
reason to conclude that it is hungry, it is more 
often wet or uncomfortable. By encouraging this 
broken night's rest babies get into the habit of 
sleeping good during the day and lying awake at 
night. When the infant gets into this habit, it must 
be broken at once. If it continues to cry after 
being made comfortable a little boiled water sweet- 
ened with saccharin usually succeeds in lulling it 
to sleep. After two or three nights of this water 
cure, it ceases to awaken. If it does not a warm 
bath at bedtime makes the infant so drowsy that 
it sleeps until daybreak. 

Great care must be exercised that the baby is 
not crying from lack of nourishment. This can 

62 



INFANT FEEDING 

be settled by weighing it before and after every 
feeding. If it is not making weekly gains it is 
safe to say that it is not receiving sufficient food. 
During the first two months a baby should gain 
five or six ounces weekly. From three to six 
months, four to five ounces weekly and towards 
the end of the year, two to three ounces. If there 
are no scales handy, the following symptoms are 
a good criterion as to the sufficiency of the mother's 
milk: 

If the infant is receiving enough nourishment 
it sleeps from one period to the other, looks bright 
and rosy, has a plump body, urinates twice as 
often as it is fed and has two to three normal yel- 
low stools daily. 

If the mother's supply of milk is small but of 
good quality, and nearly all is absorbed, the stools 
will be few in number. 

Too Much Milk 

Quite frequently it happens that a mother has 
too much milk. The infant is very uncomfortable 
after each nursing, suffers from colic, diarrhoea or 
constipation, regurgitation, sleeps restlessly, cries 
a great deal and wets many diapers. In these 
cases the mother should drink during the day as 
little fluid as possible, and the infant should be 
allowed to nurse only six to seven minutes instead 
of fifteen to twenty minutes. Many of these re- 
gurgitating, colicky infants are taken from the 
breast and put on the bottle because the mother 
does not think the breast milk is agreeing with 
the baby, when all that is required is to regulate 
the amount at each nursing. In these cases it is 
absolutely necessary to have a scales to check one's 
observations. 

Too Little Milk 

If the mother has too little milk the infant frets 
continuously, is pale and weak, sleeps from weak- 

63 



CARE AND FEEDING OF THE INFANT 

ness on the breast, does not gain in weight, wets 
few diapers and has brownish stools, or no stools 
at all. For this condition the mother should drink 
at least a quart of fluid daily, preferably milk and 
soup. Often Malt, in one form or another, has a 
good effect. Before and after each nursing the 
breasts should be lightly massaged, preferably to- 
ward the nipple. The best results are obtained 
when the breasts are emptied after each feeding. 
Quite often this deficiency of milk is due to the 
fact that the infant is not strong enough to empty 
the breast each time. In these cases the breast 
must be emptied after each period either by hand, 
breast pump or another stronger infant. Remark- 
able results are obtained by this emptying the breast 
completely. Massaging and pumping of the breast 
by hand must be done very carefully, as there is 
danger of injuring the sensitive mammary gland. 

Injury to the Breast 

Unless the prospective mother has taken some 
care in preparing her breasts for nursing before 
the advent of the baby, the nipples are apt to suffer. 
This is especially the case when the baby grapples 
only the nipple without any of the surrounding 
breast tissue. At times they become so sensitive 
and fissured that the mother fears the nursing 
period. These nipples should be protected with 
a shield and the fissures require treatment with 
tannin and alcohol. If the fissures are neglected 
an inflammation or mastitis of the breast is apt 
to result with fever and frequent chills. On ac- 
count of the great pain many mothers give up 
nursing on the affected side. This is a bad practice 
both for the baby and for the mother. If the 
mother does not nurse on the affected breast it 
becomes much more congested with milk, increas- 
ing the pain, and inflammation, so it is better for 
the mother to exert all her will power and nurse 

64 



INFANT FEEDING 

the baby. The milk does the infant no injury. 
The affected breast should be under the care of 
a physician continuously. 

Wet-Nursing 

If the mother can not nurse her babe and can 
afford it, it is better to resort to a wet-nurse. There 
is no foundation for the impression that the wet- 
nurse's baby must be the same age as the other 
infant. The only thing to guard against in such 
circumstances is, if the infant is very young and 
the wet-nurse has a large supply of milk, that it 
does not overfeed. The other danger lies in the 
fact that if the wet-nurse is not nursed dry, her 
milk will begin to disappear. On this account and 
on account of the high mortality among babies of 
wet-nurses, it is better to take both the mother 
and her child. The wet-nurse's infant can have 
the breast after the other baby has been sufficiently 
fed. Most wet-nurses can supply milk for two 
infants. Demand creates supply in breast milk 
more than in any other commodity. If the wet- 
nurse is separated from her baby, she is often in 
an excitable condition, which is bad for her milk. 

Before a wet-nurse is engaged both mother and 
child should be subjected to a complete examina- 
tion from head to toe and one must be careful 
that another infant is not substituted. The physi- 
cian should determine whether the mother is in 
absolutely good physical condition, and the breasts 
should be examined to determine whether there is 
a good supply of milk. She should be examined 
particularly for evidence of tuberculosis, syphilis, 
gonorrhea, contagious diseases and vermin. 

The nurse's baby should be examined to see 
whether it is absolutely healthy and that it is not 
tainted with hereditary diseases. 

After the nurse has been examined and found 
healthy she should have a bath and a fresh supply 

65 



CARE AND FEEDING OF THE INFANT 

of garments before handling the infant. She should 
follow the same precautions as the mother. 

The wet-nurse, though a very important per- 
sonage, should not be pampered. Her diet should 
consist of the things to which she is accustomed. 
She should have a moderate amount of work to 
do, and should exercise daily in the open air. A 
too great change in mode of life, work and food 
often results in her milk drying up, or at least 
disagreeing with the infant. 

The care of the child should be carried out 
exactly as if it were on the mother's breast. Dur- 
ing the first few days it should be weighed before 
and after nursing to be sure that it is getting enough 
and not too much. 

Feeding of the Breast-Fed Infant After the 

First Six Months and Between the 

Sixth and Seventh Month 

The breast-fed baby requires additional food. 
It has been found that infants who are fed ex- 
clusively on the breast do not flourish as they 
should. They become pale, constipated and some- 
times "cranky" or apathetic. This is due in part 
to a deficiency of iron. The full term baby comes 
into the world with a depot of iron which is said 
to be stored away during the last days of pregnancy. 
At the end of six months this supply is exhausted; 
milk being very poor in iron does not keep it up, 
and it has been found that the above symptoms 
disappear on giving food rich in iron. So the 
breast-fed baby requires certain things from the 
seventh or eighth month on. 

Fruit juice is the first requirement. It can be 
given in small quantities two or three times daily. 
It is best to begin by giving one teaspoonful im- 
mediately before the bath. This quantity can be 
increased gradually up to one ounce. Orange juice 
is undoubtedly the most satisfactory to give; if 

66 



INFANT FEEDING 

oranges are difficult to obtain the juice from an 
apple or apple sauce proves satisfactory. The juice 
of almost any fruit but strawberries can be used; 
strawberries have an idiosyncrasy for many people 
and cause urticaria. 

Besides the fruit juice, soup or beef juice and 
a vegetable are required. The mid-day nursing 
period can be substituted for one of soup or beef 
juice and vegetable. The soup, preferably chicken, 
pigeon, beef or mutton, should be thoroughly 
cooked and strained and about five ounces given. 
After the soup two teaspoonsful of spinach or carrot 
puree may be given. This quantity can be in- 
creased later. Spinach is especially to be recom- 
mended, as it is very rich in iron. Frequently 
mothers complain because spinach appears to them 
undigested in the stool, but the valuable part of 
the extractives has been absorbed. 

Sometimes the meat broths do not agree with 
an infant. The baby reacts with diarrhoea or Lichen 
Urticatus. In these cases a meal soup prepared 
as follows can be given: 

One level tablespoonful of oats or barley meal 
are cooked with a little butter, salt, and sometimes 
sugar, in a pint of water. The mixture should be 
thoroughly cooked for thirty minutes, until about 
one-half of the original amount of fluid remains. 
Milk can be used instead of water. 

After the teeth come the infant can be given 
a piece of zweibach to nibble on. Great care must 
be taken that it does not choke. 

Weaning 

Between the ninth and twelfth month the in- 
fant should be weaned. It is better to avoid wean- 
ing during the summer, so it may be necessary to 
keep up the nursing over this time. The weaning 
should be done gradually, one period at a time, 
being substituted for the bottle. The first bottle 

67 



CARE AND FEEDING OF THE INFANT 

should be given for a week, then a second period 
substituted, etc.; three to four weeks should be 
taken in the process. If the baby is of normal 
weight and is about nine months old it can be 
given a seven or eight ounce mixture, two-thirds 
certified milk and one-third boiled water, or better 
still, oatmeal or barley water. The preparation of 
this mixture will be found elsewhere in this book. 
It can gradually be increased to full milk. 

Eggs should not be given during the first fifteen 
months. They are the chief cause of Lichen 
Urticatus. When eggs are given the yolk is the 
preferable part. It can be cooked and stirred into 
the soup and given at mid-day. 

Schedule for Breast-Fed Baby in Seventh 
Month 
6:00 A. M.— Breast. 

8:45 A. M. — Orange juice, teaspoonful — increased 
gradually to one ounce at first year. 
9:00 A. M.— Breast. 
12:00 M. — Soup four or five ounces; or beef 
juice one ounce. 
3:00 P. M.— Breast. 
6:00 P. M.— Breast. 
9-10 P. M.— Breast. 

Schedule for Ninth and Tenth Month 

6:00 A. M.— Breast. 

8:45 A. M. — Orange juice one ounce. 

9:00 A. M.— Breast. 
12:00 M. — Soup four or five ounces; or beef 
juice one to two ounces. 
Spinach or carrot or potato puree — 
at first three to four teaspoons (grad- 
ually increase). 
Apple sauce two or three teaspoons. 

3:00 P. M.— Breast. 

9:00 P. M.— Breast. 

68 



INFANT FEEDING 

Schedule From Tenth to Twelfth Month 

(Following the Weaning of the Baby) 
6:00 A. M. — Farina (see directions) two to three 
ounces with a little milk and sugar. 
Milk four or five ounces in bottle. 
8:45 A. M. — Orange juice one ounce. 
9:00 A. M. — Bottle — seven ounces. 
12:00 M. — Soup — mutton, beef, veal, chicken or 
pigeon with a little rice or barley or 
well-cooked farina added. 
Puree spinach, carrots, potato, cauli- 
flower blooms — five or six teaspoons. 
Apple sauce, scraped prunes — four or 
five teaspoons. 

Bottle — three to four ounces, if neces- 
sary. 
3:00 P. M. — Bottle — seven ounces. 
6:00 P. M. — Bottle— eight ounces. 

When the baby is weaned it is always advisable 
to begin with a dilution intended for a much 
younger infant. After the weaning is completed 
then the strength of the mixture should be increased 
to age and body requirements. In this way there 
is much less opportunity of completely upsetting 
the infant. 

Breast and Artificial Feeding Combined 

Mixed Feeding 
Often it happens that the mother has not enough 
breast milk to nurse her infant successfully. In 
these cases both breast milk and milk from the 
bottle should be given. The mother should be 
encouraged at any rate to keep her baby absolutely 
on the breast for the first three months. It gets 
a start in life this way which can not be made 
up in any other. Further, it has been proved that 
the infant can not handle carbohydrates in any 
quantity until after the third month; so the mother 
should do everything possible to augment the supply 

69 



CARE AND FEEDING OF THE INFANT 

of her milk; this can be influenced to some extent 
by drinking large quantities of fluid. 

After the third month if her supply is not suf- 
ficient the difference can be made up with a cow's 
milk mixture. Under no circumstances should the 
infant be totally weaned. When the mother's sup- 
ply is not sufficient there are two methods of pro- 
cedure: One is to alternate breast and bottle feed- 
ings, and the other is to make up with the bottle 
the deficiency obtained from the breast. 

In the latter method proceed as follows: 

The infant should be weighed and then allowed 
to nurse. After the nursing it should be weighed 
again to ascertain the amount it has obtained. 
When the quantity is insufficient it should be made 
up with a feeding from the bottle, the formula 
corresponding to the age and needs of the infant. 
Artificial feeding should always be made as difficult 
as possible, otherwise the infant soon learns that 
it is easier to drink from the bottle than to nurse 
from the breast; on this account a nipple with a 
very small hole should be used and the infant com- 
pelled to drink slowly. 

When the breast and bottle alternate it is best 
to start the first feeding on the breast, give the 
second from the bottle and so on during the day. 
The formula used here should likewise correspond 
to the age and requirements of the infant. 

The day's schedule should be arranged as fol- 
lows: 

6:00 A. M.— Breast— left. 
9:00 A. M.— Bottle. 
12 :00 M.— Breast— right. 
3>00 P. M.— Bottle. 
6:00 P. M.— Breast— left. 
10:00 P. M.— Breast— right. 

Often it is sufficient when only one bottle is 
given. This is best given at noontime and at first 
the effort should be made, to get along with one 
substitution. 

70 



INFANT FEEDING 

Artificial Feeding 

By artificial feeding of infants we mean feed- 
ing with food other than breast milk. For this 
purpose either cow's or goat's milk is used. It 
should only be resorted to when the mother is 
too ill to nurse, when she has not milk enough or 
none at all, when it is impossible to have a wet- 
nurse or when for some reason or other it is neces- 
sary for mother and child to be separated. There 
is no question but that breast milk is the food 
for the infant, and as before stated, not only do 
breast-fed babies thrive better and develop stronger, 
but their resistance against infection is superior to 
artificially-fed ones. So the weaning of the baby 
should be deferred and the mother should make 
every effort to nurse her infant, if not for nine 
months, for as long a time as possible; three months 
of breast feeding gives an infant a start it cannot 
obtain any other way. Of course there are many 
babies who develop into a healthy childhood on 
artificial food, but these are the youngsters with 
such strong resistances and constitutions that they 
would thrive anyway. It is a fact that the majority 
of babes who succumb to one complaint or another 
are bottle fed. 

In breast milk the infant receives a fresh, un- 
tainted food at body temperature which nature 
intended for the weak digestion of a baby, and 
through the strenuous work of nursing the gradually 
wearying infant is prevented from over-feeding. 

The artificially-fed infant receives a food in- 
tended for a totally different organism. It is harder 
to digest, never absolutely fresh, and is apt to be 
infected through handling. The infant does not 
have to work for artificial food and as a result 
the digestion is not prepared and stimulated as 
is the case by nursing, and as the infant does not 
tire so rapidly it is apt to result in over-feeding 
with indigestion, colic, etc., as a result. 

71 



CARE AND FEEDING OF THE INFANT 

In some ways goat's milk is better than cow's 
milk. It is practically tuberculosis free, and is 
not subject to infection with typhus and diphtheria 
bacilli. However, in the city it is almost impos- 
sible to get goat's milk and when we speak of 
artificial food it almost always means cow's milk. 

Requirements of Good Cow's Milk 

The milk must come from healthy cows. It 
must be fresh, clean, undiluted, unskimmed and 
must contain no preservatives and no pathogenic 
organisms and at least three per cent fat; this is 
a law in Germany. 

The cows must be free of tuberculosis, especially 
the euters; there must be no inflammation about 
them, no intestinal catarrh, foot and mouth disease, 
glanders or anthrax. They must be kept in clean, 
airy stalls and should spend part of each day in 
the open air. They should not be fed entirely 
on dry fodder; it makes the percentage of fat too 
high; neither must they be fed entirely on green 
alfalfa or grass. It is apt to cause colic and 
diarrhoea in babies. The milk must come from a 
herd of cows and not be confined to one, and the 
animals must be examined every once in awhile 
by a veterinary. 

It is also necessary that the personnel of the 
dairy keep their hands absolutely clean and they 
must be free of all diseases, especially infectious 
in nature. 

As soon as the cow is milked the milk should 
be strained and immediately cooled, so as to hinder 
the growth and further development of bacteria. 
The best milk to use is the so-called certified. 
There is no likelihood of preservatives being used, 
and it is not falsified, that is, diluted with water 
or skimmed milk. Certified milk is so obtained 
that the number of bacteria are limited. In 
ordinary milk that one buys at a grocery there 

72 



INFANT FEEDING 

are 100,000 bacteria to the c. cm. In certified 
milk there are about 10,000 and it is possible to 
obtain it with only 200 to the c. cm. 

When milk is delivered to the house the main 
thing is to keep it cool enough to prevent the 
bacteria from multiplying. For this purpose it 
should be put in the ice-chest or kept in a basin 
filled with cold water, which should be changed 
frequently. In feeding young infants unless one 
is absolutely sure of the milk it is better either 
to boil, sterilize or pasteurize it. 

Boiling the Milk 

A special double boiler should be provided for 
this purpose. The required amount for the day 
is then boiled for five minutes and is cooled as 
rapidly as possible. It is best cooled and pre- 
served in the same utensil in which it was boiled, 
then there is no chance of it becoming reinfected 
through handling. This can be done by cooling 
it with ice or cold, running water. 

Boiling the milk makes many changes in its 
composition. Certain natural ferments, believed to 
be of value in digestion, are destroyed, part of the 
lactose is turned into caramel, the lactalbumen is 
partially coagulated, it becomes more difficult for 
the rennin to coagulate the casein, organic phos- 
phorous is changed into an inorganic phosphate, 
a volatile sulphide is liberated which shows evi- 
dence of a change in proteids and several salts 
which are usually soluble are rendered insoluble. 

Moreover, there are clinical reasons which make 
one believe that the nutritive properties of milk 
are impaired by heating, and these are the occur- 
rence of scurvy and Rickets in infants who are 
fed upon boiled milk for any length of time. Boiled 
milk predisposes to constipation and should only 
be resorted to temporarily. 



73 



CARE AND FEEDING OF THE INFANT 

Sterilizing 

Sterilization is the term used to designate the 
heating of milk for the destruction of bacteria. 
However, it should be understood that sterilizing 
milk, while it destroys the greater number of the 
bacteria, still leaves the spores, which develop 
under favorable circumstances. It is on this ac- 
count that after milk is sterilized or boiled it should 
be rapidly cooled to prevent further development 
of the spores. Bacteria cannot develop in the cold. 

Soxhlet inaugurated sterilizing of milk in 1886 
and provided an apparatus for this purpose which 
is used to the present day and which cannot be 
improved upon. He recommended that the sterili- 
zation should continue under pressure at 212° F. 
for one and one-half hours. This, however, is not 
required. All that is absolutely necessary is to 
fill the bottles for the day with the required number 
of ounces; they are then stoppered with a special 
rubber cap or cotton, and are fitted into a tray 
with a perforated bottom. This tray then fits into 
a tin boiler with a cover. After the bottles are in 
place the boiler should be filled with cold water 
up to the level of the mixture and the lid fitted 
on. Now the water is allowed to boil for five 
minutes; this exposes the bottles on all sides to 
live steam. 

After five minutes are up the milk must be 
rapidly cooled, best by allowing cool water to run 
into the hot water; this prevents the bottles from 
cracking. After the bottles are cooled they must 
be kept in a cool place until desired for use. Im- 
mediately before giving the bottle to the baby the 
milk should be heated to a lukewarm temperature, 
as cold milk is apt to cause colic. 

Pasteurization 

In order to avoid the chemical changes brought 
about by boiling the milk, but still to destroy the 

74 



INFANT FEEDING 

bacteria it is possible to pasteurize it. By this pro- 
cess the milk is heated for one-half hour at a tem- 
perature of 155°. This destroys most of the germs 
and by rapidly cooling it the rest of the bacteria are 
prevented from developing. 

Boiling, sterilizing and pasteurizing destroy 
many of the properties of milk which make it valu- 
able as a food. Not only is the milk changed chem- 
ically but it predisposes to the development of 
scurvy, so there is no question but that raw milk 
is the most satisfactory and if it is possible to obtain 
a good certified milk free from pathogenic bacteria 
and especially of tuberculosis, it should be used. 
But for the great masses certified milk is too expen- 
sive, so when necessary to use ordinary milk it 
should always be boiled, sterilized or pasteurized. 
Pasteurized milk should be cooled rapidly in cold 
water, never by placing on the ice; it takes too long 
to cool — at least one and one-half hours. 

Bottles and Nipples 

It is necessary to keep all the utensils which 
come in contact with the infant absolutely clean 
and steril. The most desirable ' baby bottles are 
round and have the ounces marked off on the sides. 
They are the easiest to keep clean and it is pos- 
sible to keep an exact account of the number of 
ounces which the infant drinks. After being used 
the bottles should be immediately cleaned with hot 
water, at least they should be filled with cold, to 
prevent the milk from drying in them. Before 
being rinsed they should be thoroughly cleansed 
with a brush and hot soda solution; then they 
should be rinsed in boiling water and turned up- 
side down to drain. 

The nipples are made of rubber and after being 
used should be rinsed inside and out with tap water. 
They should be boiled at least once a day and taken 
out of the boiling water with a pincers and dried 

75 



CARE AND FEEDING OF THE INFANT 

with a cloth. They should be kept dry in a covered 
dish or kept covered in a boric solution, from which 
they are taken and thoroughly rinsed out before 
being used. 

When a new nipple is to be used the hole should 
be burnt in it with a hot needle. The size of it 
should be regulated according to the consistency of 
the food — small for water, large for thin gruels. 
It should not be made too large, otherwise the 
infant drinks too rapidly and is apt to have colic or 
regurgitate. 

Rules for Feeding 

Periods : With bottle-fed babies it is just as im- 
portant to have long periods between feedings as 
with the breast ones. It requires longer for the 
infant's stomach to empty itself of the more indi- 
gestible cow's milk than breast milk. In the first 
four weeks the periods must be at least three hours 
apart, as follows: 

Six, Nine and Twelve A. M.; Three, Six and Nine 
P. M. and once during the night. 

If possible four hour periods are better: 

Six and Ten A. M.; Two, Six and Ten P. M. 

The infant should have a long rest at night, 
preferably for six or eight hours. Before giving the 
bottle it should be heated to body temperature. One 
must be careful that it is not too hot as it is apt to 
burn the infant's mouth, therefore it should be 
tested before being given. If it is not found too 
hot for the eyelid or cheek, it is about right for 
the infant. The temperature should never be tested 
by sucking on the nipple. To prevent the milk from 
becoming too cool it should be wrapped in a woolen 
cloth, and heated once or twice during the feeding. 

When the bottle is ready the infant should be 
laid on its side and the nurse should hold the bottle. 
She should never prop it up on a pillow and go off 
and leave the baby to drink by itself. It is contrain- 

76 



INFANT FEEDING 

dicated from many standpoints. The infant is apt 
to choke on the nipple, or it is apt to slip so deep in 
the throat that it excites vomiting or regurgitating 
or the infant is apt to drink the bottle dry and then 
continue to swallow air which is one of the chief 
causes of colic, or it is apt to lose the nipple from 
its mouth and the nurse find the cold bottle un- 
touched by the baby's side. If the bottle is reheated 
valuable time is lost and the period between the 
next feeding is shortened. Or the milk may leak 
into the bed and then it is impossible to say how 
much the infant has obtained. Sometimes the baby 
goes to sleep and the milk continues to flow. It may 
be inspired into the lungs and result in a fit of 
choking. 

Weak infants require continual encouragement 
to make them drink. 

The diapers should always be changed immedi- 
ately before the infant is fed, not after, as handling 
at this time often causes regurgitation. 

The infant should not be allowed to drink 
longer than twenty minutes, nor quicker than 
fifteen minutes. Sometimes it will not drink until 
the nurse presses the sides of the nipple together 
and so squirts some of the warm fluid into its 
mouth. The nipple must never be moistened in the 
nurse's mouth. 

After the infant has finished the bottle it should 
be held up for a moment in the nurse's arms until 
it belches whatever air it has swallowed during the 
sucking. This prevents colic and regurgitation. 

Whatever milk the baby leaves in the bottle 
should be thrown away and not used again. 

If milk is to be carried on a journey not longer 
than ten hours the required amount should be 
heated and carried in a sterilized thermos bottle. 
After ten hours the milk should not be used. If 
sterilized milk is kept on ice it will keep for two 
or three weeks; pasteurized for two or three days. 

77 



_ 



CARE AND FEEDING OF THE INFANT 

The artificially-fed infant should be weighed 
twice a week, so that the nurse or mother is able to 
tell whether it is gaining sufficiently on the formula 
and to compare it with the weight of a normal baby 
of the same age. The weighing should always be 
done at the same time of day and under the same 
conditions, preferably just before the morning bath. 
However, whether the infant is gaining is not the 
only and most important sign of its thriving. The 
development of the functions of the body, sitting 
up, standing, walking, its general appearance, the 
color and demeanor are more important. The chief 
thing that concerns the mother is whether the infant 
gains, and the most important thing w T hich delights 
the physician is whether the baby is lively, whether 
the color is good and whether it learns to stand 
and to walk at the proper time. 

Preparation of Artificial Food 
No two babies can be fed alike and no baby can 
be fed by a scheme or by age or by what some 
other infant throve on. The physician in charge 
should make a study of every individual case, and 
snould feed it by requirement and by body weight. 
It has been found that every infant, in order to gain, 
requires after the first three weeks and during the 
next three months approximately 100 calories per 
kilogram body weight. Some infants do not digest 
fat well, some get in trouble with the carbohydrate, 
so that every infant requires individual study and 
treatment. As one author has said: "A ready made 
formula does not succeed with the average baby 
any more than ready made clothes fit the average 
man." They all require taking in here or letting 
out there, and the same is true of the formula. 
That is why the mother should consult a reputable 
physician often, so that he may become familiar 
with the baby and meet requirements as they arise. 
She should never follow the advice of some old 

78 



INFANT FEEDING 

friend or nurse or the directions which come with 
prepared foods. There is no doubt but that the 
feeding infant should be under the care of a 
physician at least during the first year, and he 
should see the infant at least once every two weeks. 
Most mothers do not know when Rickets, Scurvy 
or intestinal diseases are developing until it is too 
late and the baby requires long months of treat- 
ment to restore it to a normal condition. 

Most infants can not digest whole cow's milk 
and it has to be modified and the younger the 
infant is, the more modification the milk requires, 
and the sugar must be added to bring the percent- 
age of carbohydrate up to that found in mother's 
milk. 

In the first two or three weeks the cow's milk 
should be diluted with boiled water to which the 
desired amount of sugar has been added. 

After the third month it is advisable to dilute 
the milk with a very thin oatmeal or barley water, 
which increases the value of the mixture as a food. 
Before the end of the third month it is not to be 
recommended as it has been found that up to that 
time the infantile digestion can not take care of 
large quantities of starch, so purposely the oatmeal 
and barley water is made thin at first. After three 
months it should be prepared with one rounded 
tablespoon of oatmeal or barley, and cooked in one 
pint of water for one hour. At the end of that 
time boiled water should be added to make up for 
the evaporation and the mixture strained. 

If for any other reason it is impossible for the 
baby to be fed on the breast and it is necessary to 
begin immediately with artificial feeding it is wise 
to choose a very weak milk modification or a whey 
formula. The directions for the preparation of 
whey will be found elsewhere in this book. During 
the first day, as before stated nothing is required. 
Beginning with the second, small amounts of a milk- 

79 



CARE AND FEEDING OF THE INFANT 

water or a whey-milk mixture can be given and the 
following scheme may be followed. 



Age 


No. and quantity 


Total 


Preparation of 


Sugar 


of each feeding 


quantity 


mixture 


2 day 


7 fd?8. of y s oz. 


3*4 oz. 


Whey 




8 day 


7 f dgs. of 1 oz. 


7 oz. 


Whey 19 oz., whole milk 1 oz. 




4 day 


7 fdgs. ofl tolHoz. 


10% oz. 


Whey 19 oz., whole milk 1 oz. 




5 day 


7 fdgs. of iy 2 oz. 


ioy 2 oz. 


Whey 19 oz., whole milk 1 oz. 




7 day 


7 f dgs. of 2 oz. 


14 oz. 


Whey 18 oz., whole milk 2 oz. 




14 day 


7 f dgs. of 8 oz. 


21 oz. 


Whey 17 oz., whole milk 4 oz. 




3 & 4 week 


7 fdgs. of 3 oz. 


21 oz. 


8. wr. 14 oz, w. m. 7 oz., 


1 oz. 


2 month 


7 fdgs. of 4-4% oz. 


32 oz. 


B. wr. 18 oz, w. m. 14 oz., 


1 OS. 


3 month 


7 fdgs. of 4% oz. 


32 oz. 


B. wr. 16 oz. w. m. 16 oz., 


l%os. 


4-6 month 


7 fdgs. of 5% -6 oz. 


42 oz. 


0. wr. 18 oz, w. m. 24 oz., 


l%oz. 


"•9 month 


6 fdgs. of 7 oz. 


42 oz. 


0. wr. 12 oz, w.m. 30 oz., 


iy 2 oz. 



Abbreviations — B. wr., boiled water; w. m., whole milk; o. wr., 
oatmeal water. 

From the tenth month on the infant should be 
gradually accustomed to whole milk so that by the 
end of the twelfth month it is unnecessary to dilute 
it farther. 

Instead of using whey-milk formulas during the 
first two weeks simple milk and water dilutions may 
be used. 



Age 


No. and quantity of 


Total 


Preparation of 


Sugar 


each feeding* 


Quantity 


mixture 


2 day 


7 f dgs. of % ox. 


sy t oz. 


B. wr. 18 oz, w. m. 2 oz., 


loz. 


8 day 


7 fdgs. of 1 oz. 


7 oz. 


B. wr. 18 oz, w. m. 2 os., 


1 OS. 


4 day 


7 fdgs. of 1% oz. 


10 oz. 


B. wr. 17 os, w. m. S os., 


los 


7 day 


7 fdgs. of 2 oz. 


14 os. 


B. wr. 16 os, w. m. 4 os., 


1 oz. 


14 day 


7 fdgs. of 2% to 3 oz. 


21 oz. 


B. wr. 14 os, w. m. 6 os., 


1 OS. 



Abbreviations — B. wr., boiled water; w. m., whole milk. 

Simple schemes for feeding in the first months: 

First day — nothing. 

From second day on — 6 to 7 feedings — 1-3 milk; 
2-3 water; 1-2 teaspoon sugar, to each feeding. 

From second month on — 6 to 7 feedings — 1-2 
milk; 1-2 water; 1 level teaspoon sugar, to each 
feeding. 

From sixth month on — once soup and vegetable; 
6 feedings — 2-3 milk; 1-3 oatmeal water; 1 level 
teaspoon sugar, to each feeding. 

80 



INFANT FEEDING 

From ninth month on — once soup and vegetable; 
once cooked meal and milk; four times full milk. 

Scheme for the amount of each feeding from 
first day to ninth day: 
First day — nothing. 

Second day 6 feedings x 10 grams (1-3 oz. or 

1 tablespoon.) 

Third day 6 feedings x 20 grams (2-3 oz.) 

Fourth day 6 feedings x 30 grams (1 oz.) 

Fifth day 6 feedings x 40 grams (1 1-3 oz.) 

Sixth day 6 feedings x 50 grams (1 2-3 oz.) 

Seventh day ..6 feedings x 60 grams (2 oz.) 
Eighth day ....6 feedings x 70 grams (2 1-3 oz.) 

Ninth day 6 feedings x 100 grams (3 1-3 oz.) 

Scheme for the mixture: 

It is much better to under-feed a baby than to 
over-feed it, and at no time during the first one-half 
year should the total quantity of milk which an 
infant receives in twenty-four hours exceed one 
quart. Too much fluid results in distention of the 
stomach. It should never exceed one-sixth of the 
total body weight in grams, and the amount of milk 
should not exceed one-tenth. According to this rule 
an infant weighing thirty-six hundred grams (ap- 
proximately seven and one-quarter pounds) should 
receive three hundred and sixty grams of milk (or 
twelve ounces) diluted with oatmeal gruel or barley 
water up to six hundred grams (twenty ounces), 
one-sixth body weight. 

Pfaundler of Munich formulated the following 
rule for the artificially-fed baby between two and 
six months, which is very practical: 

1/10 of the body weight in grams in fresh milk. 
1/100 of the body weight in sugar. 
Dilute up to one quart with barley or oatmeal 
water and divide into six bottles. 



81 



CARE AND FEEDING OF THE INFANT 

Sugar 

Of the sugars, Cane and Milk Sugar are the 
cheapest, and therefore the most frequently used. 
Milk Sugar or Lactose is the same sugar that is 
found in mother's milk. However, it ferments very 
easily and is often troublesome on that account. 
Cane Sugar is sweeter than Milk Sugar and ferments 
less easily. Both are disacharides. 

The Maltose preparations are the best to use. 
They ferment less easily, are more easily digested 
and prevent constipation. 

Prepared Foods 

It is better to avoid all prepared foods. Certified 
milk, sugar, one or two cereals and vegetables are 
all that we need to insure the thriving and develop- 
ment of the infant. The prepared foods never 
prove satisfactory substitutes for the products of 
nature. Condensed milk is especially to be avoided. 
It is adapted for sea trips or long journeys or for 
places where it is impossible to obtain a fresh sup- 
ply of milk, but it is not adapted for continuous 
feeding. Many children apparently thrive on it, 
that is they are fat and white, but not an ideal 
picture of health. A large number are affected with 
chronic affections such as Rickets. 

The Pacifier 

Many nurses and mothers in the pauses between 
feedings give their charges a rubber nipple to suck 
upon. This is a habit which is best avoided. The 
pacifier is difficult to keep absolutely clean. It 
rolls on the floor and the careless attendant, with- 
out washing it off, gives it to the baby again. In 
this way it is easy for the mouth to become in- 
fected. The babies addicted to the pacifier swallow 
great quantities of air and suffer from colic. How- 
ever, the pacifier is to be preferred in preference 

82 



INFANT FEEDING 

to the habit of sucking on the thumb or one of the 
fingers. The finger or the finger-nail becomes de- 
formed in one way or another and several authors 
have claimed that it has resulted in an irregularity 
in the growth of the teeth. 

Crying After the Bottle 

Because a baby cries on finishing the bottle is 
not always a sign that it is hungry; almost all bottle 
fed babies do. The breast baby at the end of twenty 
minutes nursing, is so tired that it goes right to 
sleep, not so the artificially fed. Drinking from a 
bottle does not tire it out and the infant realizes 
only that the supply is exhausted, never that it is 
satisfied. So because it cries should not make the 
parents think that it is unsatisfied. 

It is much better to have the infant under the 
care of a physician than to try following written 
formulas, as milk has to be especially modified for 
every infant. 

During the first few days as noted in the scheme, 
the infant is satisfied with small quantities. During 
the whole twenty-four hours it will not drink more 
than two or three ounces. The amount increases 
gradually so that by the end of the second week it 
drinks at each period between two and three 
ounces. As the baby grows older it has an in- 
creased capacity and requirement, so the amount 
should be gradually increased from time to time, 
but never when it is making daily gains and ap- 
pears satisfied, and never because it is a week older 
or because it is written on the table. After the 
first three or four days the number of feedings 
should be increased to seven, that is every three 
hours. The amount should be gradually increased 
in accord with the desires of the infant. Finally 
its capacity will be reached, usually at the end of 
the first month, when the amount averages between 
four and five ounces. After this time the total 

83 



CARE AND FEEDING OF THE INFANT 

quantity is not increased but the concentration, so 
that by the tenth or twelfth week the infant is re- 
ceiving one-half milk and one-half water and one 
teaspoon sugar at each feeding. From this time no 
change should be made without an indication, that 
is if the baby ceases to gain or seems fretful after 
the bottle. 

When the infant has reached the age of six 
months it should have a teaspoon of orange juice 
before the morning bath and during the seventh 
month the mid-day bottle, completely or in part, 
should be substituted for broth — chicken, veal, beef 
or mutton, prepared according to directions found 
elsewhere in this book. If desired two or three 
ounces of the milk mixture may be given after the 
soup, or the bottle usually given at that time may 
be divided among the other feedings so that the 
infant receives just as much milk in the twenty- 
four hours. Between the ninth and tenth months 
mixed food should be given. In the morning for 
breakfast the infant should have a small plate of 
farina or well cooked oatmeal, followed by the 
bottle; at noon the soup, followed by two or three 
teaspoons of a vegetable puree and one or two tea- 
spoons of apple sauce, so that the diet between the 
ninth and tenth months should be as follows: 
6:00 A. M. — Farina 2 or 3 ozs. with milk and a 
little sugar. 

Bottle of milk— 6 to 7 ozs. 
Before the bath — Orange juice — 1 to 2 ozs. 

9:00 A. M.— Bottle. 
12:00 M. — Soup — veal, mutton, beef, chicken — 4 
to 5 ozs. or beef juice 1 oz. 
Vegetables — spinach, carrot or cauli- 
flower puree — 2 or 3 teaspoons. 
Apple sauce — 1 to 2 teaspoons. 
Bottle if desired. 
3:00 P. M.— Bottle. 
6:00 P. M.— Bottle. 

84 



INFANT FEEDING 

At the twelfth month the infant should be on 
whole milk and the diet from the twelfth to the 
fifteenth month as follows: 
6:00 A. M.— Breakfast — cereal; bottle of milk. 
9:00 A. M.— Bottle. 
12:00 M. — Soup: with addition of well cooked 

rice, barley or farina — 5 to 6 ounces. 

Or beef juice 1 to 2 ounces. 

Vegetables: Potato puree, spinach or 

carrot puree. 

Fruit: apple sauce, baked apple or 

mashed prunes. 
3:00 P. M.— Bottle. 
6:00 P. M. — Supper — A little well cooked cereal — 

2 to 3 ounces. 

Zweibach prepared according to di- 
rections. 

Milk. 
From the eighteenth to the twentieth month, five 
feeding periods in the course of the day are suffici- 
ent. Three of these should be larger than the other 
two, so that at this age the child begins with break- 
fast and ends up with supper. Eggs may be given 
at this time, but preferably the yolk; it may be 
stirred into the soup or given at supper time with 
bread crumbs. At noon time scraped beef may be 
given, prepared as directed. A good schedule for 
this is as follows: 
7:00 A. M. — Breakfast — Cereal, well cooked; milk; 

zwiebach, one piece. 

1 ounce of orange juice before morn- 
ing bath. 
10:00 A. M.— Bottle of milk. 
12:00 M. — Dinner — Soup; 6 to 7 ounces, with 

addition of well cooked pieces of 

vegetables, rice, barley, squares of 

toast or yolk of an egg. 

Scraped beef, chop or steak prepared 

according to directions. 

85 



CARE AND FEEDING OF THE INFANT 

Vegetables: spinach or carrot puree; 
summer squash; blooms of cauli- 
flower; string beans; cooked lettuce. 
Potatoes — pureed, baked, boiled, thor- 
oughly mashed. 

Dessert: apple sauce, baked apple, 
mashed prunes. 
4:00 P. M.— Bottle of milk. 

6:00 P. M. — Supper — Well cooked cereal; milk 
toast; milk custard; floating island; 
rice, with additions of cooked fruit 
or fruit juices. 
Bottle of milk. 
At two years the daily schedule would be as 

follows : 

Breakfast: Cereal with sugar, salt and a little milk. 
Or soft boiled egg with dried bread 
crumbs, three times a week. 
Crisp bacon once a week. 
Stale bread and butter or zweibach. 

10:00 A. M. — Orange juice, 2 ounces. 

Dinner: Soup, as previously directed, with ad- 
ditions of barley, rice, yolk of an egg, 
vegetables, etc. Or beef juice, 1 to 2 
ounces. 

Meats : lamb chops, steaks, roast beef, 
white meat of chicken or turkey 
scraped or cut into very small pieces. 
Vegetables: Spinach, carrot, cauli- 
flower, lettuce or peas pureed. String 
beans, ends of asparagus and arti- 
choke, all thoroughly mashed. 

Dessert: Mashed prunes, baked apple or apple 
sauce. 
6:00 P. M. — Supper: Cereal with warm milk or 
milk toast. 
Or plain custard. 

Or rice and apple baked together with 
berry juice. 

86 



THE MOST FREQUENT 

COMPLAINTS AND DISEASES 

OF THE INFANT 



THE DISEASES OF THE INFANT 

Blennorrhoea 

This affliction results from infection of the 
baby's eyes at the time of birth and is the 
most dangerous of all the diseases which as- 
sail the new-born. Many infants have been ren- 
dered, through lack of care, absolutely blind. As 
soon as possible after birth, for the sake of pre- 
caution, the eyelids should be separated and each 
eye cleaned with separate pledgets of cotton and 
boric acid and a drop of 5-10 per cent argyrol left 
between the lids. If, in the course of the next two 
days, it is noticed that the eyelids are swollen and 
that there is a discharge, a physician should be sum- 
moned, as the least delay is oftentimes disastrous. 
The disease begins in the second or third day after 
birth. In the beginning there is only swelling and 
redness of the lids and the lashes are stuck together. 
In the course of the next day the lids become more 
swollen and inflamed and a pus discharge ap- 
pears between the lids. On the first appearance of 
pus a smear should be made for examination for 
gonococcus; if it is positive not a moment is to be 
lost. Ice water compresses must be applied to the 
affected eyes and changed every five minutes and 
the pus must be sponged away before it has time 
to collect. The infant should lie on the side of the 
affected eye and the sponging should be done away 
from it. It is a good plan to cover over the unaf- 
fected one with isinglass. The nurse and the 
mother must use every precaution to keep their own 
eyes from becoming infected. The ice compresses 
have to be changed night and day every five min- 
utes, and the pus should never be allowed to col- 
lect under the lids as there is continuous danger of 
perforation of the cornea, and so loss of sight. 



89 



CARE AND FEEDING OF THE INFANT 

Scurf 

In many infants during the first months there is 
an increase in the production of the sebaceous 
glands, especially on the head. There results a 
brownish, yellow, fatty mass or collection of scales. 
This becomes mixed with dust and bacteria and 
ultimately has an unpleasant odor. This mass must 
be removed as soon as possible, and is accomplished 
by softening it with boric acid and vaseline or 
warm oil, applied best at night; the next morning 
the head is washed with warm w T ater and soap and 
the hair combed with a fine-tooth comb. 

Intertrigo 

This is a light form of eczema which occurs 
mostly about the buttocks, between the legs, under 
the arms and about the neck. The skin becomes 
red, tender and moist and itches exceedingly. It 
results from the acidity of the urine or stools, from 
negligence and carelessness in not changing the 
diapers as often as necessary and most frequently 
from diarrhoea or insufficient drying after the bath. 

It responds readily to cleanliness and frequent 
changes of diapers. Absolute dryness and treatment 
with boric acid and vaseline are all that are neces- 
sary. Often it is advisable to give bran baths. 

When more serious it is necessary to consult a 
physician. 

Bednar's Aphthae 

Bednar's Aphthae, named after the distinguished 
pediatrician of Vienna, who first described the two 
symmetrical ulcerations on either side of the roof 
of the mouth over the hamular processes of the 
palate bone. These ulcerations seen in the new- 
born and very young infants are the result of 
traumaticism at the time of birth. The nurse in 
cleaning out the mouth exerts too much pressure 
over the external head of the pterygoid muscle and 

90 



DISEASES OF THE INFANT 

the result is that the mucus membrane is abraded, 
and the bacteria on the finger and in the mouth thus 
gain a foothold and an ulceration results. 

It may be so painful that the infant refuses to 
nurse or it may attempt to do so and then give up, 
crying. Sometimes it is accompanied by greenish 
stools. 

Usually it requires no treatment; when neces- 
sary it should be handled by a physician. Aqueous 
solution of boric acid and 5 per cent Silver Nitrate 
applied with an applicator are the best remedies. 

Thrush or Soor 

This is a parasitic growth on the mucus mem- 
brane of the mouth of the infant. It is really a 
fungus and looks like white irregular spots or 
curdled milk on the mucus membrane. It is gen- 
erally located on the inside of the cheeks and on the 
tongue. 

It results from an abrasion of the mucus mem- 
brane — following clumsy handling — thus the fungus 
is able to obtain footing. Unclean nipples, breasts 
and fingers are a source of infection. 

It is sometimes accompanied by fever and intes- 
tinal disturbances and generally requires medical 
attention. The infants often refuse to nurse on ac- 
count of pain. 

In the milder cases applications of boric acid 
prove sufficient; in the more severe cases, more 
radical treatment under the advice of a physician 
should be inaugurated. 

Aphthous Stomatitis 

In this condition, small superficial yellowish 
ulcerations are found in the mucus membrane of 
the cheeks, gums, and edges of the tongue. It is 
accompanied by fever, considerable pain, saliva- 
tion and green stools. 

It requires constitutional handling and the infant 
should be under the care of a physician. 

91 



CARE AND FEEDING OF THE INFANT 

Colic 

Colic is due to disturbed intestinal conditions. 
Cold and chilling are predisposing factors. It oc- 
curs both with artificially and breast-fed infants* 
With bottle-fed infants the more frequent causes 
are: Too much food; too frequent feedings; prep- 
aration given too cold; too quickly swallowed or 
percentage of fat or carbohydrate is too high. With 
breast-fed babies the following causes are noted: 
Errors in the mother's diet or the taking of cathar- 
tics; chemical changes in the milk brought about by 
chilling the breasts; weariness or mental upsets due 
to grief, joy, anger or fatigue. Habitual colic is 
often caused by cold feet, so the first thing to do 
for the relief of the baby is to see that the feet are 
warm, by wrapping them in a warm blanket or 
placing them against a hot water bottle. By mouth, 
give two to three ounces of hot camomile or fennel 
tea. If the abdomen is distended, apply hot dry 
flannel cloths, or compresses dipped in camomile 
tea; let the body lie on a hot water bottle or rub 
the abdomen gently with warm olive oil; this starts 
the wind. If the colic still continues give an enema 
of hot water or hot camomile tea or introduce a 
rubber catheter into the rectum to relieve the gas. 
If these measures are not successful summon a 
physician. 

Convulsions 

On account of the inco-ordination of the nervous 
system, infants are predisposed to convulsions. 
Sometimes the first one occurs at the time of teeth- 
ing. They are often the prodrome not only of dis- 
eases of the brain, but also of the lungs, intestines 
and the acute infectious diseases. They also occur 
with babies who are disposed to holding their 
breath. They require immediate preventative treat- 
ment, as the habit is said to predispose to epilepsy 
later in life. 

92 



DISEASES OF THE INFANT 

The convulsion may begin with an extremity, 
about the mouth, the forehead or the eyes and 
spread from there, over the entire body. The infant 
becomes pale, unconscious, rolls the eyes backward, 
foams at the mouth, the lips become pale, the mus- 
cles of the face and the extremities twitch, and the 
urine and stool may be evacuated. It lasts from a 
few minutes to hours. The longer the convulsion 
lasts, the more dangerous is it to life, and it is neces- 
sary for the mother or nurse to accomplish as much 
as possible before the doctor arrives. 

The head of the infant should be kept high and 
covered with an ice-bag or cloths wrung out of ice- 
water. If the attack is a light one, rubbing the skin 
briskly with a wet crash towel until it is red and 
giving a high, hot, colon irrigation often proves suf- 
ficient. When more severe, the infant must be given 
a hot mustard pack and the feet put in a mustard 
bath. The pack is prepared by rolling the infant 
in large towels which have first been dipped in 
mustard water (two large tablespoonfuls of mustard 
to the quart of hot water) . 

If the convulsions continue over a long time and 
the infant is becoming blue and the circulation 
shows evidence of failing, it should be given a hot 
mustard bath. The ears should be first stopped up 
with cotton before the infant is dipped in the water. 
In female infants a pledget of cotton should be 
inserted between the labia. The temperature of the 
water should be at least 103° F. and the nurse should 
test it with a thermometer. If this precaution is not 
taken the infant is apt to be burned. 

A quick purge should be given and the food re- 
duced to a minimum to ward off subsequent attacks. 
All further medication should be directed by the 
physician in charge. 

It is frequently necessary to administer chloral 
or some other hypnotic. Such remedies should 
only be used when necessary. 

93 



CARE AND FEEDING OF THE INFANT 

Nasal Catarrh 

Catarrh of the nose is one of the most danger- 
ous afflictions of infancy, and on this account any 
member of the family afflicted with a head cold 
should stay away from the baby, and above all 
should not kiss it. The mother while nursing should 
tie a handkerchief about her head and nose, as it 
is very infectious. Not only is catarrh unpleasant 
for the baby, but it interferes with nursing and 
spreads very easily to the respiratory passages, re- 
sulting in tonsillitis, bronchitis, pneumonia, or to 
the ears resulting in ear diseases of one kind or 
another. As a precautionary measure, before the 
infant takes its outing, especially in raw weather, 
the nostrils should be lightly smeared with vaseline. 
In this way any bacteria which might be inhaled 
are impaled in the vaseline, which is removed when 
the infant returns to the house. 

If the running nose develops into a bloody dis- 
charge, it is suggestive of diphtheria or lues. If 
fever and a cough develop, a physician should be 
consulted. 

Earache 

From the beginning of infancy on, too careful 
attention cannot be directed toward the ears. Neg- 
lect of frequent attacks of inflammation often results 
in complete deafness. When the baby has an ear- 
ache it cries out sharply, bores its head into the 
pillow, puts up its hands to the afflicted side and 
cries out whenever the ear is touched. It results, 
frequently from a head cold, inflammation of the 
mouth (thrush or stomatitis), adenoids and inflam- 
mation of the throat. The least discharge from the 
ear requires the most careful treatment and should 
be under the care of a specialist. After the morn- 
ing bath the ears should be carefully dried out with 
cotton. 

The treatment consists in irrigation with a warm 
boric acid solution and the application of heat. 

94 



DISEASES OF THE INFANT 

The latter is best applied with a spiall hot water 
bottle or a bag filled with hot salt. All other medi- 
cation should be left to the physician. 

Constipation 

This is one of the most frequent complaints of 
infancy, and is due to over-feeding, under-feeding, 
heredity or some pathologic condition in the intes- 
tines. The cause must be very carefully gone into 
before treatment is begun. Most frequently it is due 
to errors in diet and therefore it is a great mistake 
giving a physic which relieves the condition, with- 
out curing the cause. Until proper dietary regula- 
tion is begun, it is much safer giving an enema with 
hot water or one tablespoonful of sweet oil, or one- 
half or one teaspoonful of glycerine in water, or a 
decoction of camomile tea, or soap and water solu- 
tion or a suppository. The most satisfactory and 
safest to use over any length of time, are injections 
of hot water or camomile tea. Glycerine and soap 
enemas, when continued, are irritating to the bowel. 

One should always wait two days before resort- 
ing to an enema. The injection should be given 
with a bulb syringe which holds about two ounces. 
The tip should be of soft rubber so as not to irritate 
the rectum or injure the mucus membrane. It is a 
bad practice regulating the bowels with enemas and 
cathartics. They are best regulated in young babies 
by the diet. Increasing or substituting Malt Sugar 
or a Malt preparation, if Cane and Milk Sugar have 
been used, usually relieves the condition. In older 
children, orange juice, just before the morning bath, 
may be given; after six months a mixed diet con- 
sisting of one or two teaspoonfuls of spinach or 
carrots puree and apple sauce may be added to the 
bill of fare. 

Also after six months one can begin training the 
baby by putting it on the stool regularly every morn- 
ing at a certain time, best just before the bath. The 

95 



CARE AND FEEDING OF THE INFANT 

infant should be encouraged at this time to have a 
passage; light massage of the abdomen twice a 
day stimulates peristalysis; at the same time a little 
sweet oil may be rubbed into the abdomen. In 
massaging one should begin in the right groin, then 
ascend to the ribs, cross to the other side and down 
to the left groin. This should be continued for five 
minutes or so. Or one may use deep massage, begin- 
ning in one groin and moving the fingers in a circle 
towards the umbilicus. 

Boiled, sterilized and pasteurized milk and an 
exclusive milk diet, predispose to constipation. Too 
much fluid causes a distension, tires and lessens the 
amount of work which the intestines can do; on this 
account the total amount of fluid ingested in twenty- 
four hours should be kept down. 

Croup 

Croup is a very alarming condition especially as 
it may develop during the night without warning. 
Exposure to cold and wet are predisposing factors. 
During the day the nurse or mother may not have 
noted that the infant had a coryza and a slight tem- 
perature. During the night it may awaken showing 
signs of difficulty in breathing, with a hollow, dry, 
barking cough. The dyspnoea may be extreme; the 
baby sits upright, gasping for breath; the face be- 
comes pale and bathed in perspiration and the tem- 
perature may be elevated to 102° or 103°. 

Usually croup is spasmodic in nature and ap- 
pears more alarming than it really is. It is usually 
not dangerous, but is apt to be repeated for three 
or four nights. One attack predisposes to others. 

If the attack is persistent and does not improve 
or grows worse, as the night wanes, one should 
think of diphtheria and a physician should be 
summoned. 

Treatment of Croup — Keep the room warm. Ap- 
ply counter-irritants to the neck and chest; a 

96 



DISEASES OF THE INFANT 

mustard plaster best serves the purpose here (pre- 
pared by mixing with a little water one table- 
spoonful of mustard and six tablespoonfuls of 
flour and spreading on cheesecloth; to avoid blis- 
tering grease neck and chest with vaseline be- 
fore applying poultice). Place the infant under 
a tent made over the crib, improvised by throwing 
a sheet over an opened umbrella; keep the tent 
filled with steam from a croup kettle, which should 
be saturated with turpentine or tincture benzoin. 
To relieve the laryngeal spasm induce emesis by 
administering twenty drops of the Syrup of Ipecac 
every two hours. If the symptoms are urgent it is 
best to have a physician at hand, as it may be neces- 
sary to intubate. The attacks are frequently re- 
peated for two or three successive nights. 

Vomiting and Diarrhoea 

As well as being the symptoms of a gastric and 
intestinal upset, both vomiting and diarrhoea are fre- 
quently the prodromata of some other disease, espec- 
ially those infectious in nature. 

The first thing to be done is to limit the amount 
of food and keep the infant quiet. If the symptoms 
are not particularly severe, all solid food should be 
stopped and the milk freely diluted to reduce the 
fat and no addition in the way of sugars should be 
made to the mixture. If the symptoms are alarming, 
all food and milk should be stopped and boiled 
water or camomile tea given by mouth in small 
amounts every two or three hours. 

The second thing to do is to give a cathartic — 
calomel or castor oil, the dose being regulated ac- 
cording to the age of the infant. 

Crying 

The most frequent complaint to deal with in 
babies is crying, and no greater mistake can be made 
than to imagine that because a baby cries it is 

97 



CARE AND FEEDING OF THE INFANT 

hungry, and therefore to give it more food without 
investigating further into the cause — there are many 
others than lack of food. Neither should the infant 
be taken out of bed, carried in one's arms or rocked 
to and fro. The thing to do is to investigate. 

The chief causes are as follows: 

A new-born baby cries because it longs for its 
mother; it wants to feel the warmth of her presence 
and snuggle close to her body. A hot water bottle, 
comfortably near, pacifies these infants. 

Or it cries because it is hungry or over-fed. At 
first it is hard to get accustomed to the three-hour 
periods; when it comes to food most babies cry 
because they are over-fed and have colic. 

Or they are wet and have lain for a long time in 
damp clothes and are uncomfortable, or the diapers 
or bands are too tight and the clothes are chafing, 
or the little buttocks and legs are sensitive and ex- 
coriated, or there is something foreign in the dia- 
pers, or it is too hot or too cold, a safety pin is 
sticking it or it is constipated and the bowels are 
full of hard stools which cannot be passed, the stom- 
ach is dilated with gas or an insect or a flea is biting 
it or it is thirsty, or it is the beginning of an acute 
illness, or it is feverish, or has an earache and bores 
its head into the pillow and puts its hands to the 
ears, or there is a diastasis of the recti muscles, um- 
bilical hernia, fissure in ano, or in male babies a too 
tight foreskin or it may be a nervous baby when too 
much talking in the room, lights, and coming and 
going disturb it. 

Or the mother is a nervous, excitable woman and 
her condition only aggravates that of the infant. 
Often these babies quiet down by putting them in 
charge of a calm, phlegmatic nurse and banishing 
the mother temporarily. 

More often these crying babies are over-fed and 
the omission of one feeding and the substitution of 
a bottle of boiled water works wonders. Unless 



DISEASES OF THE INFANT 

one is positive that it is hunger, it is a mistake to 
give more food or to feed more frequently. 

If the baby is constipated or the abdomen dis- 
tended, the infant should be given an enema. How- 
ever, the habit of giving enemas should not be 
started. The bowels should be regulated through 
the diet. 

If the infant is thirsty it immediately becomes 
quiet on giving it water or a weak solution of cam- 
omile tea. 

Often a warm bath and a bed warmed with a 
hot water bottle subdues it, or if the crying is due 
to colic, placing it face down with a hot water bottle 
under the abdomen, or rubbing the little stomach 
with warmed olive oil or placing hot, dry com- 
presses soaked in camomile tea over the abdomen 
quiets and relieves it. 

Often one or two ounces of warm, sweetened fen- 
nel or camomile tea by mouth are comforting. 
Sometimes it is necessary to introduce a catheter 
into the rectum to relieve the gas. Under no cir- 
cumstances should narcotics, sleeping potions or 
drugs be administered without the advice of a 
physician. 

If no reason is found for the restlessness, the 
infant should not be allowed to cry over too long a 
period; crying is work and requires strength, and 
by continuing it the baby becomes too tired to drink, 
does not gain in weight and often diarrhoea results. 

Sometimes if the infant is a nervous one, it be- 
comes quiet when it has a pacifier to suck on. When 
it continuously endeavors to suck on the finger it is 
better to supply one. Under these circumstances it 
must be kept absolutely clean; before being given to 
the baby it should be washed with fresh water, and 
at least once a day, boiled. Under no circumstances 
should a bone or pacifier made of cloth stuffed with 
bread or zweibach be given. 

Often a crying baby's attention can be distracted 
by a play-toy. 

99 



TRAINING OF THE INFANT 



TRAINING OF THE INFANT 

Training begins with the birth of the infant. 
Many parents think it is not necessary to begin 
until the child is three or four years old and 
base their opinion on the fact that the small infant 
cannot reason, but the baby is impressionable and 
can appreciate cause and affect long before the intel- 
ligence is awakened. From birth on the infant can 
r>e taught regularity and after a few months obedi- 
ence and cleanliness in habit. 

The first thing to inaugurate is absolute regular- 
ity, and this begins with the feeding periods. Many 
mothers give the baby the breast and later the bottle 
every time it cries. This is wrong. In the first 
place it is exceedingly bad for the digestion and in 
the second place the infant is not taught regularity. 
The feeding periods should be every three hours 
and it soon realizes this and awakens as regularly as 
a clock when the hour comes round. To get the 
infant into this habit, there being no reason to the 
contrary, it should be awakened at first, regularly 
for its feedings and it soon begins to regulate the 
naps by these periods; in this way the mother avoids 
the dangers of over-feeding and the infant is given 
its first lesson in temperance in eating. 

As soon as the baby is able to sit up it should be 
taught cleanly habits. One can begin with the fifth 
or sixth month. Most infants wet their diapers soon 
after their naps and after nursing. On this account 
it is a good practice to put them on the chamber as 
soon as possible after waking up and after feeding. 
Care must be exercised after nursing, as the food is 
easily regurgitated at this time. From the position, 
it soon begins to realize what is expected of it; a 
warm chamber accelerates urination and a cold one 
prevents it. 

By careful observation it is easy to tell when the 
infant is about to have a bowel movement. The 
face becomes flushed; it makes straining move- 

103 



CARE AND FEEDING OF THE INFANT 

ments and grunts. After these signs are noted, 
it should be put on the chamber. After a few 
weeks of this systematic training the infant will 
begin to make its desires known by a peculiar 
cry or by grunting. As soon as possible it should 
be trained to have its stool at a certain time every 
morning, preferably just before the bath, and it 
should be put on the chamber at the same time, 
whether it has a stool or not; this forming of a 
habit makes the greatest difference in the whole 
future development. While the infant is on the 
chamber it should be protected from drafts and 
under no circumstances should it be given anything 
to play with; toys at this time distract its attention, 
and everything should be done to bring about a 
sense of realization of its position. It should not be 
left too long on the chamber as the position predis- 
poses to prolapse of the bowel. 

After the second year it should not wet the bed 
at night; it is best controlled by not giving the child 
any fluids after four P. M. A semi-solid diet should 
be given at the usual supper hour. At about ten 
P. M. the infant should be put on the chamber. It 
should also be kept off the back, by making it more 
comfortable to sleep on the side. A slight elevation 
of the foot of the bed is efficacious in keeping press- 
ure off the neck of the bladder. If bed wetting con- 
tinues after two and one-half years the urine and 
the genital organs should be examined for some 
source of irritation. 

The mother and nurse should avoid allowing the 
infant to get into any habit as sucking a finger or 
thumb, rubbing a piece of blanket or giving it a 
pacifier when it cries. The finger or finger-nail is 
apt to become deformed by constant sucking and it 
has been claimed that malformations of the upper 
teeth have developed from such a practice. There 
is also constant danger of infection of the mouth 
with thrush or stomatitis resulting. The constant 

104 



TRAINING OF THE INFANT 

sucking also stimulates the secretion of saliva and 
disturbances of digestion result. 

At all hazards the habit of sucking on the fingers 
or thumb should be broken. If necessary the infant 
should wear mittens or the elbows should be put in 
splints so that it is impossible to get the hand to 
the mouth; or bands of adhesive plaster should be 
put around the favorite finger or the nails should be 
painted with Tincture of Quinine. 

A normal baby does not require these means of 
pacification. However, if the infant is accustomed 
to a pacifier it is better to give it one than to allow 
it to suck continuously on the finger or to cry for 
hours. Continual crying and fretting results in loss 
of weight, intestinal disturbances and predisposes 
to hernia of one form or another. Under these cir- 
cumstances the pacifier chosen should be one that 
can be kept absolutely clean. 

As before mentioned the infant should be kept in 
a room by itself with no loud talking or bright 
lights or other noise to disturb its rest. It should be 
so trained that it goes to sleep on being put in its 
cradle. The ultimate result depends on the begin- 
ning. It should not get into the habit of being 
rocked, walked or sung to sleep; sitting by the bed 
and holding one of the little hands is just as bad a 
habit. Further, every time it cries it does not re- 
quire taking up or patting. Once this habit is begun 
it has to be continued. The nurse should see that 
it is dry and comfortable and that is all that is 
necessary. 

The infant must also learn obedience. It is not 
necessary to wait until the third or fourth year. It 
should be made to realize the difference between 
the things it can do and cannot, from the beginning. 
It should never be given playthings when it cries or 
whines for them. It should be made to understand 
that the desired object is refused because it is 
naughty. Sometimes all that is required is an ener- 

105 



CARE AND FEEDING OF THE INFANT 

getically spoken word or look. The infant soon 
realizes cause and effect. It is a bad practice to 
spank a little baby. As the infant grows older it 
should never be bribed into doing things. It should, 
from the beginning, be taught who is in authority. 

Playthings 

As everything given the baby ultimately reaches 
the mouth this eventuality in the selection of toys 
should be borne in mind and the following things 
avoided: 

All articles artificially colored, as the dye is very 
frequently poisonous. 

All articles made of lead, as there is danger of 
poisoning. 

All things covered with cloth; they become 
soaked in saliva and cannot be kept clean, and an 
infection of the mouth is apt to result. 

Toys covered with feathers, hair or fluffy ma- 
terial; pieces are apt to be swallowed resulting in 
coughing, or more serious complications. 

All toys with sharp corners or points, and all 
small articles like rings, whistles, coins, etc. These 
articles are easily swallowed or poked into the ear 
or nose. 

The most suitable toys are made of rubber, bone 
or ivory. Very attractive rubber things can be 
bought in the shape of animals, dolls, etc. Celluloid 
articles are satisfactory providing they do not 
come in contact with fires, lights, etc., as they are 
explosive. 

One must be very careful of leaving thimbles, 
needles, tacks and pins around as they are easily 
picked up and swallowed. 

When an article is swallowed and the mother or 
nurse is confident that it has reached the stomach 
the child should be fed bread crumbs, crusts, zwei- 
bach, etc. These foods have a tendency to coat the 
article over with faecal material and prevent it 

106 



TRAINING OF THE INFANT 

injuring the susceptible mucus membrane lining of 
the intestine. Never should a cathartic be given, as 
it increases the fluidity of the intestinal contents 
and the swallowed article instead of being coated 
over with faecal material, sinks against the walls of 
the intestine by virtue of its own weight and is not 
discharged. A cathartic also has a tendency to 
increase peristalysis, and so to injure the intestinal 
mucus membrane. 

Airing 

Fresh air is as necessary as fresh milk to a 
thriving baby. On this account it should be given 
an airing on every suitable day. In Summer the 
new-born infant can be given its first outing after 
the first week — a calm sunny day should be chosen. 
In the Spring, Fall and Winter it should not be 
taken out until it is three to four weeks old. For 
the first few times it should not stay out longer than 
one-half hour; gradually the time can be lengthened. 
The middle part of the day should be chosen, except 
in the heat of Summer when the house is the 
most appropriate place. It should never go out until 
one hour after the bath, until the early morning fog 
has cleared, and it should always be brought into 
the house as soon as the sun has gone down. 

On windy, rainy, snowy, foggy and very cold 
days it should remain indoors. 

All things considered it is better for the infant 
to be given its airing in the baby buggy rather than 
in the arms of the nurse. In the buggy it is pro- 
tected from drafts and can be warmly covered. 
When the infant is carried it should be shifted from 
one arm to the other often, otherwise it is apt to 
develop a lordosis or become more proficient with 
one arm than the other. 



107 



SPECIAL DIRECTIONS 



SPECIAL DIRECTIONS 

Enemas 

1. Camomile Tea: One teaspoon camomile leaves. 
Pour eight ounces of hot water over the leaves and 
allow to steep for three minutes. Strain through 
cheesecloth. Now it is ready for use. 

This makes the most satisfactory enema. It is 
non-irritating and soothing. 

2. Salt Solution: Six-tenths per cent. 

3. Glycerine: One teaspoonful glycerine to one 
ounce of water. Glycerine enemas are very good 
because it is not necessary to inject a large quantity 
of fluid. However, glycerine, when continued, is 
irritating to the rectal mucus membrane. 

4. Soap-Water: Solution of warm water and a mild 
soap such as Castile. This is not one of the best 
measures as the soap is irritating to the bowel. It 
should never be used with young babies. 

5. Sweet or Olive Oil Enemas: Two tablespoonfuls 
olive oil to one and one-half ounces of warm water. 
This makes a good mild enema. One teaspoonful of 
olive oil alone may be injected with satisfactory 
results. 

6. Decoction Senna Leaves: One dessertspoonful to 
one quart of hot water. This makes a strong enema 
and usually gives a good result without irritation. 

Quantity 

Infant one to two ounces. 

Child three to eight ounces. 

Position 

The child should lie on the right side with knees 
and thighs flexed while the tip of the syringe is 
inserted into the rectum. Or the child should lie on 
its back with the buttocks elevated. Older children 
may assume the knee-chest position, that is to kneel 
upon the bed, resting the fore part of the body on 
the elbows. 

Ill 



CARE AND FEEDING OF THE INFANT 

A rubber bulb syringe with a hard rubber tip 
about four or five inches long make the most satis- 
factory syringes. 

The tip should be properly lubricated before 
being inserted. 

After the enema has been injected the syringe 
should be quickly withdrawn and the buttocks 
pressed together to prevent the expulsion of the 
fluid. Sometimes it is necessary to repeat the injec- 
tion before a satisfactory result is obtained. 

Temperature 

With an infant the temperature is best taken in 
the rectum. Groin, axillary and mouth temperatures 
prove less satisfactory. The quicksilver should be 
shaken below 98° before being inserted. The mother 
or nurse should see that the thermometer is abso- 
lutely clean, by cleansing it, first in a disinfecting 
solution and finally with alcohol. Then it should be 
lubricated with albolene or vaseline, and with the 
infant on the right side or back, with buttocks ele- 
vated, should be inserted for one-half or three- 
fourths of an inch. It should be then held in 
position one to two minutes, the infant being kept 
absolutely quiet to prevent any injury to the mucus 
membrane. A normal infantile temperature ranges 
between 98%° and 100°. When it is below 98° the 
infant requires artificial heat. After the tempera- 
ture is taken the thermometer should be cleaned in 
a disinfecting lotion and the quicksilver shaken 
down. 

High Enemas 

For use in acute catarrhal colitis and for remov- 
ing poisonous and irritating excreta. 

The child should lie on the right side. A soft 
rubber catheter should then be introduced into the 
rectum and inserted as high as possible. The med- 
icament, under gentle pressure should be introduced 

112 



SPECIAL DIRECTIONS 

through a funnel attached to the catheter. Then the 
funnel, catheter, etc., should be lowered so that the 
fluid may run off. This procedure should be re- 
peated until the water runs clear. 

For this purpose hot normal salt solution, tan- 
nin, 1%; 1% Liquor Alumini Acetatis; hot water 
or camomile tea should be used. 

Garlic Tea 

For removal of pin worms, make a decoction of 
garlic, from a piece the size of a chestnut and six- 
teen ounces of water, boiling for one-half to one 
hour, straining and adding boiled water to make up 
for evaporation. This decoction should be injected 
for two or three days. 

Poultices 

Mustard Plaster: One tablespoonful Coleman's 
mustard; six tablespoonfuls flour and mix in a bowl 
with enough water to make a paste. Then take a 
doubled piece of cheesecloth, large enough to cover 
the afflicted part, spread the mustard paste on it 
and cover with another piece of cheesecloth. Then 
smear the skin lightly with vaseline to prevent blis- 
tering and apply the mustard plaster. It should be 
left in place until a good reaction is obtained, and 
then the skin lightly powdered with talcum. 

Cold Compress 

Take a piece of woolen or flannel cloth and cover 
it with a thin sheeting of oiled silk or rubber. Then 
a piece of gauze folded four thicknesses to the de- 
sired size, is wrung out in lukewarm or cold water 
and placed upon it. The compress is folded about 
the afflicted part; the sheeting must be wider than 
the wet compress. It can be changed every one- 
half hour or remain longer in place. Unless the 
compress is properly applied it does more harm 
than good. 

113 



CARE AND FEEDING OF THE INFANT 

Cold Pack 

A valuable procedure to reduce temperatures. 

Upon a hard surface, as a table, a woolen blanket 
is spread out. A sheet wrung out in cold water or 
room temperature water is spread out upon the 
blanket and the naked infant placed in the middle 
of the sheet, which is then quickly folded about the 
child from chin to toes, and over it the woolen 
blanket is folded so that all the open spaces are 
closed up. The child should not be in this pack 
longer than ten to thirty minutes. 

The cold pack is only successful when following 
the initial shock the patient feels well. The blood 
vessels dilate and the whole body becomes red. If 
the patient remains pale or blue he should be taken 
out and the pack not repeated. 

After being taken out of the pack the skin should 
be thoroughly dried and the patient laid in a warm 
bed. If there is a good reaction after the bath it- can 
be repeated many times. 

Flaxseed Poultice 

Take one ounce of flaxseed. (The meal cooks 
quicker than the seeds.) Add one pint of cold water 
and cook in a double boiler until a thick paste re- 
sults. If the water evaporates too quickly add water 
until the proper consistency has been obtained. The 
seeds require a longer preparation. Then the paste 
is spread upon gauze or cheesecloth, and properly 
contained, folded about the part. Flaxseed poultices 
should be changed every one-half hour. 

Mustard Bath 
Three to five handfuls of freshly ground mustard 
flour are confined in as many bags of gauze, and 
added to two quarts of warm water, where they are 
heated, not boiled. Then this water, bags and all, is 
added to the bath and the infant is immersed and 

114 



SPECIAL DIRECTIONS 

left until a good skin reaction is obtained. The ears 
of all babies and the vagina of girl babies must be 
protected with pledgets of cotton. 

Salt Baths 

One pound of Lurline or Carmel Bath Salts to 
the bath. 

Bran Bath 

Take one pound of white bran; sew it or tie it 
in a linen bag and cook for one-half hour. 

Then hang the bag in the bath and squeeze it. 
The bath is ready for use when the water is white 
and soft. 

Camomile Bath 

Take one-half pound of camomile leaves. Cook 
for ten minutes in two to three quarts of water. 
Strain through muslin. Add the camomile tea to the 
bath water and suspend the leaves tied in a muslin 
bag in the bath tub. 



115 



RECIPES 



RECIPES 

Whey: To one pint of whole milk warmed to 40 G. 
add two teaspoonfuls Fairchild's Essence of Pepsin 
or liquid rennet and a pinch of salt. Allow to stand 
for one-half hour in a warm place until coagulation 
has taken place. The curd should then be broken 
up with a fork and the whey strained off through a 
muslin bag. 

Junket: If it is desired to preserve the curd alone, 
it is not necessary to break it up, but the whey 
should be strained off. Junket makes a good dish 
for children from twenty months on, or earlier if 
necessary to give more solid food. 
Buttermilk: Strain a quart of buttermilk (not older 
than twenty-four hours) through a fine sieve. Of 
this take six to seven ounces; add one level table- 
spoonful and one-half of flour and mix thoroughly 
together; then add the rest of the quart of butter- 
milk and heat the whole mixture for one-half hour, 
stirring constantly. Allow it to boil up three times 
for just a second, removing it each time quickly 
from the fire, just as soon as it boils up. Before the 
final boiling up, five level tablespoonfuls of sugar — 
Cane or other sugar — should be added to the mix- 
ture. The preparation is now ready for division 
into the required number of bottles. 
Oatmeal Water — Barley Water: To one pint of 
water add one level tablespoon of Quaker Oats or 
Barley Flour. Boil in a double boiler for one hour. 
At the end of that time add boiled water to make up 
for what has evaporated, and strain through a mus- 
lin cloth. To be used for diluting purposes after 
the third month. 

Malt Soup: The original Malt Soup of Keller is pre- 
pared as follows: There are many modifications of 
this preparation. Mix fifty grams of flour in one- 
third of a quart of milk. Slightly warming acceler- 
ates the mixing. After it is thoroughly mixed put it 
through a sieve. 

119 



CARE AND FEEDING OF THE INFANT 

In another porcelain dish mix one hundred 
grams of Loefflund's Malt Soup Extract with two- 
thirds of a quart of water. Then it should be heated 
almost to the boiling point, until the Malt goes into 
solution. Then both preparations should be poured 
into one porcelain dish and the whole mixture 
brought three times to a boil. Malt Soup should 
never be used except on the recommendation of a 
physician. 

Eiweiss Milk or Proteid Milk: The first step in the 
preparation of eiweiss milk is the same as in the 
preparation of junket, and whey, with this excep- 
tion — the whey is thrown away and the curd, after 
being placed in a muslin bag, is washed in tap 
water to get rid of as much of the whey as pos- 
sible. Then it is mixed with one pint of boiled 
water and with a spoon, forced twice through a hair 
sieve, in order to break up all clumping. Then one 
pint of buttermilk is added and the mixture is 
ready to be divided into the bottles and sterilized. 
Liebig's Soup: 100 grams Malt Flour or Peeled Malt, 
100 grams flour, 10 grams 11% solution of Potassium 
Carbonate are mixed in a porcelain cooking dish. 
To this mixture one quart of milk is added and the 
whole preparation cooked over a slow fire to 60 or 
70 C. Just as soon as it cooks thick it should be 
taken off the fire and stirred vigorously for five min- 
utes. Then it should be put on the fire again until 
it is thick and stirred thin. For the third and last 
time it should be allowed to boil up three times and 
then strained. 

Gruel: To twelve ounces of whole milk add one 
and one-half to two level tablespoonfuls wheat flour, 
rice flour or Scotch oatmeal. Stir constantly for 
fifteen or twenty minutes over a medium fire, until 
thick. Add salt and one-half teaspoonful sugar. If 
desired serve with fruit juices. 

Zweibach Gruel: Powder several pieces of zwei- 
bach with a rolling pin. Of the powder take two 
120 



RECIPES 

level tablespoonfuls and add it to ten ounces of 
whole milk in a porcelain cooking dish. Cook for 
fifteen to twenty minutes stirring constantly. Add 
one-half teaspoonful butter and a pinch of salt. 

Soups 

Mutton, Veal Broth or Beef Broth: Take eight 
ounces of beef or veal or shoulder of mutton. Add 
four ounces of chopped up bone, preferably near 
the joint, a carrot and some soup greens and a quart 
and one-half of cold water and one-fourth teaspoon 
salt. Cook for two to three hours in a covered kettle 
until six or eight ounces of broth remain. Strain 
through a hair sieve and skim off the fat. This 
makes a strong broth, which may be diluted if 
desired. 

Additions may be made to this soup in the way 
of well-cooked rice, barley, arrowroot or farina, 
which increases its nutritional value. 

After the eighteenth month the yolk of an egg 
stirred into six ounces of the soup and cooked for 
two to three minutes makes a nutritious addition 
and at the same time accustoms the child to taking 
eggs. 

Chicken Broth: Take one-half a chicken or one-half 
of an old pigeon. Cut it up into parts or pass 
through a meat grinder. Add one quart of cold 
water and soup greens and cook for an hour down 
to six or seven ounces. A little well-cooked rice or 
barley may be added to this. Instead of water, veal 
or beef broth may be used. 

Beef Tea: Take eignt ounces of raw, fat-free beef. 
Cut into fine pieces and put in a pint fruit jar with- 
out the least water. Screw the cover on tight; then 
put the jar in a kettle of cold water, so that it is 
two-thirds covered, and let it boil for three or four 
hours. When necessary to replenish the bath, only 
hot water should be used. Afterwards the beef juice 
should be pressed out through a piece of cheese- 

121 



CARE AND FEEDING OF THE INFANT 

cloth or muslin. A small wine glass of beef juice is 
thus obtained. A pinch of salt should be added to 
it, and because it spoils very easily, it should be 
kept on ice. It can be served cold. It should be 
heated only in a warm bath, and then but slightly. 
The least cooking results in flakes of meat. 
Tomato Soup: Take a pound of tomatoes and cover 
them in a pot with cold water; allow them to stew 
slowly. Then together with the water in which they 
have cooked, they should be put through a sieve. 
One-fourth of a teaspoonful of melted butter and 
salt and sugar to taste should be added. Instead of 
water, broth may be used. 

Beef Juice: Take eight ounces of lean beef. Broil 
for a second on either side. Cut into squares and 
extract the juice in a meat press or lemon squeezer. 
The juice should be collected in a small wine glass 
and a pinch of salt added. If the meat is not first 
broiled, it is not nearly so palatable or delicious. 
When ready for use it should be heated in a water 
bath, never directly, as pieces of meat are apt to 
form. 

Beef Juice: Cut eight ounces of previously lightly 
broiled beef-steak into small squares and collect 
them in a muslin bag. Immerse the bag containing 
the squares of beef in about three ounces of cold 
water. Allow to stand for three hours and express 
the juice by pressure. Beef juice by this method is 
not nearly so strong as those previously described. 
Farina and Milk: Farina 1 ounce, milk 7 ounces. 
Mix together and cook over a slow fire for one hour, 
being careful that the preparation does not burn; 
stir constantly with a wooden spoon; add salt or 
sugar to taste and serve with fruit juices. 
Cereal Jelly: Of pearl barley, oatmeal or rice, — 
four level tablespoonfuls — soak in water for ten to 
twelve hours. Then add to one quart of fresh water 
and boil in a double boiler for at least four hours. 
Cook until boiled down to one pint. Strain and 
122 



RECIPES 

allow to cool. The jelly, which now forms, makes a 
nutritious addition to milk. 

Oat Gruel: Take one ounce of rolled oats and cook 
thoroughly in eight ounces of water. Strain and 
add four ounces of milk, stirring continuously with 
a wooden spoon and cooking until thick. Add one- 
fourth teaspoon butter and salt to taste. 
Gruel from Wheat or Corn Flour: Take one level 
tablespoonful of Wheat or Corn or Rice Oatmeal 
flour — add eight ounces of whole milk. Stir con- 
tinuously for one-half hour and cook over medium 
fire. Add salt and one-fourth teaspoon butter as 
desired. 

Milk Rice: Take one and one-half ounces of rice — 
wash it thoroughly in cold water. Add twelve 
ounces of milk and one level tablespoonful sugar. 
Cook steadily for one to one and one-half i^ours, 
stirring frequently. 

Apple Rice (Apfel Reis): One-half pound apples — 
peeled, cored and cut. Add one tablespoonful of 
sugar and a little lemon peel. Stew quickly in a 
little water. 

Three ounces of rice thoroughly cooked in one 
pint of water. When the rice is thoroughly cooked, 
add the apples to it. 

Apple Rice (Schlossman and Sommerfeld): Two 
ounces of rice are cooked for one hour in eight to 
ten ounces of milk. One-fourth pound of apples — 
peeled, cut and stewed soft in a little water with a 
tablespoonful sugar and a little butter. 

As soon as the rice has cooled, one egg, one-half 
teaspoon butter and one tablespoonful of sugar and 
a teaspoon of lemon juice are added and the whole 
mixture thoroughly stirred. Then a porcelain cook- 
ing dish is smeared with butter. 

First a layer of the rice mixture is spread in the 
porcelain dish, then a layer of the apple and finally 
the rest of the rice. It is put in the oven and baked 
for twenty to thirty minutes. 

123 



CARE AND FEEDING OF THE INFANT 

Oatmeal Souffle: Take four tablespoons oatmeal 
flakes; add eight ounces of milk. Cook to the con- 
sistency of a gruel and then allow it to become cold. 
Mix thoroughly together one ounce, by weight, of 
butter and one and one-half tablespoonfuls of sugar 
and the yolks of two eggs. The whites are beaten 
and mixed with the oatmeal gruel and then with the 
butter, sugar and yolk of egg mixture. The whole 
thing is then baked in a porcelain dish for one-half 
hour. 

Egg Souffle (Keller): Three level tablespoonfuls 
flour, seven ounces of whole milk and one-half 
ounce, by weight, of butter are cooked to the con- 
sistency of gruel, stirring constantly, and allowed to 
cool. Then little by little the yolks of two eggs and 
a little grated lemon or orange peel are added by 
way of seasoning, and gradually the beaten whites 
of two eggs are added. It is then cooked in a porce- 
lain dish which has been previously smeared with 
butter. 

Sago Souffle (Birk): Five level tablespoons of clean 
white sago are cooked in one pint of milk, stirring 
constantly to prevent burning, until soft. Then 
after it is thoroughly cooked it is allowed to grow 
cold in a porcelain dish. One ounce of butter is 
beaten in, the yolks of two eggs added, and sugar 
and salt according to taste. At the conclusion the 
beaten whites of two eggs are added. Then it is 
baked for three-fourths of an hour in a medium 
hot oven, in a form previously smeared with butter. 
Lemon Souffle (Schlossman and Sommer field): The 
yolks of two eggs and one teaspoonful of sugar are 
thoroughly mixed together. Then the juice of one- 
half a lemon and a little grated lemon peel are 
added and for ten minutes thoroughly mixed. 
Finally a teaspoon of flour and the beaten whites 
of two eggs are stirred in. The whole mixture 
is baked for ten minutes in a porcelain cooking 
dish smeared with butter. 

124 



RECIPES 

Apple Souffle (Birk): One pound of apples — peeled, 
cut and with two tablespoonfuls sugar placed in 
a porcelain dish. 

A gruel is made from one ounce of butter, three 
tablespoonfuls of sugar, the yolks of two eggs and 
three level tablespoonfuls of flour, four ounces of 
milk and the beaten whites of two eggs stirred in. 
This mixture is poured over the apples in the 
porcelain dish and baked for one hour in the oven. 

Vegetables 

Spinach: Take one-half pound of young spinach. 
Wash it in cold water. Then cook it for thirty 
minutes in a pint of water after adding a pinch 
of salt. The young leaves cook much quicker than 
the old ones. As soon as the spinach is thoroughly 
cooked, the water is drained off and the leaves 
chopped up as fine as possible. During this pro- 
cess the water, in which the spinach has cooked, 
is boiled down so as to preserve all the extractives, 
and added to the leaves again. A little butter is 
now added and the whole mixture is put through 
a sieve. The spinach may also be cooked in milk. 

Lettuce may be prepared in the same way. 

Carrots: Six ounces of carrots, without the greens, 
are washed, peeled and cut in disks and cooked 
slowly in a pint of water with one-fourth teaspoon 
salt for three-fourths of an hour. The water is 
drained off and boiled down to a small volume; 
one-half teaspoon butter and a little salt are added 
and the mixture pressed through a hair sieve. 

Instead of cooking the spinach and carrots in 
water, it may be accomplished in milk. Then it 
is not necessary to add butter. 

Potato Puree: Clean and peel eight ounces of mealy 
potatoes and cook in salt water (one-half teaspoon 
salt to a quart of water) for one-half hour. Drain 
off the water and dry out somewhat in the oven. 

125 



CARE AND FEEDING OF THE INFANT 

Put them through a sieve; add one-half teaspoon of 
butter and four ounces of milk and mix thoroughly. 
Puree of Green Peas: Take one-half pound of fresh 
green peas. Add five ounces of cold water or whole 
milk; one-fourth teaspoon salt and cook thoroughly 
for one hour. When cooked down put through a 
hair sieve. 

Cauliflower: Scald a small head of cauliflower. 
Wash it thoroughly in cold water. Remove the 
blooms and discard the stalk (as it is undigestible 
to an infant). Add eight ounces of milk or eight 
ounces of water. Cook thoroughly; add salt and 
butter to taste and put through a sieve. 

Fruit 

Juices of fresh berries, grapes or oranges. Ex- 
tract the juices in a lemon squeezer or fruit press. 
Remove the seeds and administer in a teaspoon. If 
sour sweeten with saccharin. 

Apple and Pear Sauce: Wash, peel, core and quar- 
ter — eight ounces of apples or pears. Add four 
ounces of water and cook thoroughly in a stew pan. 
Add two tablespoonfuls sugar and strain. 
Mashed Prunes: Take eight ounces of prunes. 
Cook thoroughly. Remove stones. Scrape meat 
free and put through a hair sieve. 
Banana Souffle: Take two bananas. Peel and cut 
into disks. Add eight ounces of milk and one- 
fourth teaspoon salt. Bake for fifteen minutes and 
strain. 



126 



INDEX 



INDEX 



Adenoids in speech, 21 
Airing, 107 
Albumen urine at 

birth, 8 
Aphthae, Bednar's, 90 
Artificial feeding, 71 
Artificial respiration, 46 
Asphyxia: treatment, 45 

Baby buggy, 41 

Barley water, 119 

Baths: Duration infant, 
29; first for infant, 26, 
27, 28; temperature 
for infant, 27, 28, 29; 
maternal during preg- 
nancy, 4; medicinal 
bran, 115; medicinal 
camomile, 115; me- 
dicinal mustard, 114; 
medicinal salt, 115 

Bed, the, 33 

Bednar's Aphthae, 90 

Beef tea, 121 

Beef juice, 122 

Blenorrhea — inflamma- 
tion eyes, 89 

Bloody nasal discharge, 
94 

Bones at birth, 17 

Bottles, 75 

Bow-legs at birth, 17 

Bow-legs and diapers, 38 

Breasts: Care of during 
pregnancy, 4; care of 
following birth, 55; 
injury to, 64; milk in 
new-£orn, 11 

Broths, 121 



Buttermilk, 119 

Cane sugar, 82 

Caput succedaneum, 10 

Carrying, 42 

Catarrh nose, 94 

Cephalhaematoma, 10 

Cereals, 122 

Cleft palate, 10, 53 

Clothes during preg- 
nancy, 3 

Clothes: Infant, 35, 36; 
night, infant, 39 

Cold pack, 114 

Colds, frequent, 35 

Colestrum, 57 

Colic, 35, 92 

Compresses, cold, 113 

Condensed milk, 82 

Constipation, 95 

Convulsions, 92 

Cord, care of, 25, 26 

Croup, 96 

Crying, 35, 83, 97 

Dentition: First set, 18; 

Pfaundler's rule, 18; 

delayed, 18; early 

symptoms of, 18 
Diapers, the, 37; chang- 
ing of, 39; soiled, 39 
Diarrhoea, 35, 97 
Diet during pregnancy, 

3; diet nursing 

mother, 54 
Diets, 84, 85, 86 
Diphtheria, 94 
Drugs excreted in 

milk, 55 

129 



INDEX 



Earache, 94 

Ears, care of, 30, 43 

Eiweiss milk, 120 

Enemas, directions for 
giving, 111, 112; in 
constipation, 95 

Epilepsy and nursing, 52 

Excitement on nursing, 
54 

Exercise, during preg- 
nancy, 4 

Eyes: Care of following 
birth, 25, 27, 29; inco- 
ordination new-born, 
12; inflammation of 
new-born, 12, 89; 
new-born, 10 

Feeding : Artificial, 71 ; 
management of, 76, 84, 
86; breast management 
of, 59, 60, 61; breast 
baby after six months, 
66, 67; breast baby 
schedules for, 61, 66, 
68; mixed, 69, 70 

Finger sucking, 104 

Fissures, breast, 64 

Fontanelles : Anterior 
and posterior, 7; clos- 
ure of, 17; in rickets, 
myxoedoema, 17; 
cretinism and hydro- 
cephalus, 17 

Food, artificial prepara- 
tion of, 78 

Formulas, artificial 
food, 80 

Fruit, 126 

Garlic tea, 113 
Genitalia female, in 
bathing, 27, 40, 115 



Gonorrheal infection 

eyes, 89 
Gruel, 120 

Hair, 7 

Hair lip, 10, 53 

Head: Change of posi- 
tion in, 33; circumfer- 
ence birth, 7; circum- 
ference one year, 16; 
following birth, 17 

Hiccoughing, 35 

Hydrocephalus, fonta- 
nelle in, 17 

Hysteria and nursing, 52 

Icterus of the new- 
born, 11 

Inco-ordination new- 
born, 9; inco-ordina- 
tion eyes new-born, 20 

Incubators, 44; benefits 
of, 44 

Infectious diseases and 
nursing, 52 

Intertrigo, 90 

Jaundice at birth, 11 
Junket, 119 

Kissing, 42 

Lactose, milk sugar, 82 
Lanugo, 7, 11 
Length: New-born, 7, 

16; new-born at six 

months, 16; new-born 

at one year, 16 
Liebig's soup, 120 
Lifting, 42 
Lues, 94 
Loefllund's: Malt soup, 

120 



130 



INDEX 



Malt soup, 119 

Maltose, malt sugar, 82 

Massage in constipation, 
96 

Measurements, new- 
born, 7, 16 

Meconium, 8 

Menstruation and nurs- 
ing, 52 

Milk: Care of, 72; 
changes due to boil- 
ing, 73; drugs excreted 
in, 55; pasteurizing of, 
74; requirements of, 
72; sterilizing of, 74; 
breast sufficient quan- 
tity of, 63; breast too 
little, 63; breast too 
much, 63; fever, 57; 
first appearance in 
breasts, 56; sugar, 
lactose, 82 

Mouth, care of, 27, 30 

Muscular development, 
17 

Myxoedoema, fontanelle 
in, 17 

Nails, care of, 30 
Nasal catarrh, 94 
Navel, 25, 26, 27, 28; 

infection of, 28 
Nervous child, 32 
Nipples, breast, sore, 64 
Nipples, rubber, 75 
Nursery, the, 31; airing 
of, 32; furnishing of, 
32; temperature of, 31 
Nursing : Contraindica- 
tions to, 51 ; difficulties 
in, 53; mother, care 
of, 54; period, dura- 
tion of, 60; the first, 
56, 58, 59 



Oatmeal water, 119 

Pacifier, the, 82 
Pasteurizing milk, 74 
Pharyngitis, 19 
Pin worms, 113 
Playthings, 106 
Poultices, 113, 114 
Pregnancy and nursing, 

53 
Premature baby: Care 

of, 43; feeding of, 45, 

62; signs of, 7 
Prepared foods, 82 
Proteid milk, 120 
Pulse: At birth, 8; in 

infancy, 8 

Recipes, 119 
Recognition, etc., 19 
Regurgitation, 34, 39 
Respiration: New-born, 

8; in infancy, 8 
Rickets: Dentition in, 
18; early signs of, 17; 
fontanelle in, 17; pre- 
pared foods, 82 

Scurf, 90 

Sight: At birth, 19; de- 
velopment of, 19 

Sleep: New-born, 9, 21, 
27; position during, 
10; requirements for, 
34 

Smile first, 20 

Soor, 91 

Souffle, 124 

Soups, 121 

Special senses, new- 
born, 10, 19 

Speech, 20; delay in, 21 

Sponge bath, 26, 27 

131 



INDEX 



Squint eyes, new-born, 

20, 41 
Sterilization milk, 74 
Stomach, new-born, 9 
Stomatitis, aphthous, 91 
Stomatitis, 19, 94, 104 
Stools at birth, 8 

Teeth: Care of, 31; or- 
der of appearance, 18 

Temperature, 9; bath, 
27; nursery, 27; sub- 
normal, 44; taking of, 
9, 112 

Thrush, 19, 31, 91, 94, 
104 

Tonsilitis, 19 

Tonsils and speech, 21 

Training, 103 

Tuberculosis, 51 

Uric acid, new-born, 8 
Urine, new-born, 8 

Vagina: Bloody dis- 
charge in new-born, 
12; care of following 



birth, 25; care of, 30, 

40, 114 
Vegetables, 125 
Vernix caseosa, 25, 26 
Vomiting: Tight clothes, 

35; treatment of, 97 

Walking, 17 

Water, bath, tempera- 
ture, 27 

Weak infants: Care of, 
43, 53; feeding of, 45 

Weaning, 67 

Weighing, 43 

Weighing, bottle-fed 
baby, 78 

Weight : During infancy, 
16; gain per week, 16; 
loss following birth, 
15; new-born, 7, 15 

Wet-nurse : Examina- 
tion of, 65; require- 
ments of, 65 

Whey, 119 

Zweibach gruel, 120 



132 



HERE ENDS THE CARE AND FEEDING OF THE 
INFANT," AS WRITTEN BY GEORGE D. LYMAN, 
A.B.,M.D. PUBLISHED IN BOOK FORM BY 
PAUL ELDER & COMPANY, AND SEEN THROUGH 
THEIR TOMOYE PRESS BY JOHN SWART, IN 
THE CITY OF SAN FRANCISCO, DURING THE 
MONTH OF APRIL, NINETEEN HUNDRED AND 
FIFTEEN 



